Active NPI
Martin C Halloran, LSW
- Addiction (Substance Use Disorder) Counselor
- Lorain, OH
National Provider Identifier
1952762619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- S.1450568
- Practice address
- 2115 West Park Drive
Lorain, OH 44053 - Phone
- (440) 989-4987
- Fax
- (440) 282-4779
- NPI assigned
- Mar 9, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | S.1450568 | OH | Primary |
Addresses
Primary practice location
2115 West Park Drive
Lorain, OH 44053
Mailing address
2115 West Park Drive
Lorain, OH 44053
Phone (440) 989-4987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S.1450568 | Other | OH | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1450568 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1952762619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 WEST PARK DRIVE",
"city": "LORAIN",
"state": "OH",
"postal_code": "44053",
"telephone_number": "440-989-4987",
"fax_number": "440-282-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 WEST PARK DRIVE",
"city": "LORAIN",
"state": "OH",
"postal_code": "44053",
"telephone_number": "440-989-4987",
"fax_number": "440-282-4779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLORAN",
"first_name": "MARTIN",
"middle_name": "C",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-09",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "S.1450568",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "S.1450568",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.