MEDICARE: MARTIN PSYCHOTHERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1467255521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN PSYCHOTHERAPY

Provider Business Mailing Address
First Line	:	236 S PRINCETON AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1667
Country	:	US
Telephone Number	:	773-329-0636
Fax Number	:

Provider Business Practice Location Address
First Line	:	236 S PRINCETON AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1667
Country	:	US
Telephone Number	:	773-329-0636
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA MARTIN
Credential	:	LCPC
Telephone Number	:	773-329-0636

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	07/31/2025

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Directions to “MARTIN PSYCHOTHERAPY ” Practice Location

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