Stacy Martin

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA120928 Issued in OH

Practice address

Tuscarawas County Alcohol and Addiction Program
897 E. Iron Ave.
Dover, OH 44622

Phone

(330) 343-5555

NPI assigned

Sep 18, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1932628385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 E IRON AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222030",
            "telephone_number": "330-343-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TUSCARAWAS COUNTY ALCOHOL AND ADDICTION PROGRAM",
            "address_2": "897 E. IRON AVE.",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "44622",
            "telephone_number": "330-343-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STACY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA120928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew M Luxenberg, M.D.
• Lyfe Counseling LLC
• Marlowe Drug Inc
• Brent Marshall
• Staci Marie Marshall, CNP
• Diana Mast, RN
• Katheryn M Maurer, CDCA
• Kristen M Maurer, ATC, PTA
• Renee Lynn Maurer
• Jennifer Elizabeth McCaslin, LPC

• Addiction (Substance Use Disorder) Counselor in Dover, OH
• Providers in Dover, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.