Active NPI
Ludwig Marcello Martinez
- Counseling Psychologist
- Jbsa-Lackland, TX
National Provider Identifier
1962937987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY.0005210
- Practice address
- Whasc
1100 Wilford Hall Loop
Jbsa-Lackland, TX 78236-1200 - Phone
- (210) 292-5972
- NPI assigned
- Apr 27, 2017
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY.0005210 | CO | Primary |
Addresses
Primary practice location
Whasc
1100 Wilford Hall Loop
Jbsa-Lackland, TX 78236-1200
Mailing address
Usafa
4102 Pinion Drive
Air Force Academy, CO 80840
Phone (719) 333-5177
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 |
|---|---|---|---|
| PSY.0005210 | CO | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1962937987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "USAFA",
"address_2": "4102 PINION DRIVE",
"city": "AIR FORCE ACADEMY",
"state": "CO",
"postal_code": "80840",
"telephone_number": "719-333-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WHASC",
"address_2": "1100 WILFORD HALL LOOP",
"city": "JBSA-LACKLAND",
"state": "TX",
"postal_code": "782361200",
"telephone_number": "210-292-5972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "LUDWIG",
"middle_name": "MARCELLO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-27",
"last_updated": "2024-06-14",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CO",
"license": "PSY.0005210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbsa-Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.