Martin D Phillips, LCDC INTERN

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

INTERN Issued in TX

Practice address

239 S Virginia St
Stephenville, TX 76401-4344

Phone

(254) 965-5515

Fax

(254) 965-7416

NPI assigned

Aug 7, 2009

Sex

Male

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Star Council

  • Community/Behavioral Health Agency
  • Cleburne, TX
  • NPI 1275807216
  NPD (past)
• Star Council on Substance Abuse

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Stephenville, TX
  • NPI 1336254184
  NPD (past)

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1972734960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W HEARD ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760333836",
            "telephone_number": "817-645-5517",
            "fax_number": "817-645-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 S VIRGINIA ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764014344",
            "telephone_number": "254-965-5515",
            "fax_number": "254-965-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARTIN",
        "middle_name": "D",
        "credential": "LCDC INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "INTERN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pecan Valley MHMR Region
• Pecan Valley MHMR Region
• Samantha Noel Pehl, NP
• Alisa Gay Peterson, DO
• Herbert Phil Phillips, LPC
• Maria Pilotte, LPC
• David Scott Pool, LPC
• Kyna Price, SLP
• Progressive Medical Management of Batesville LLC
• Robert J Prough, DDS PA

• Addiction (Substance Use Disorder) Counselor in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.