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1144765892 NPI number — ERICA DAWN MARTINO LPC, CFI, CFTS

NPI Number: 1144765892
Health Care Provider/Practitioner: ERICA DAWN MARTINO LPC, CFI, CFTS

Information about “1144765892” NPI (ERICA DAWN MARTINO LPC, CFI, CFTS) exists in 1144765892 in HTML format HTML  |  1144765892 in plain Text format TXT  |  1144765892 in PDF (Portable Document Format) PDF  |  1144765892 in an XML format XML  formats.

NPI Number : 1144765892 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144765892",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARTINO",
    "FirstName": "ERICA",
    "MiddleName": "DAWN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPC, CFI, CFTS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROLLYSON",
    "OtherFirstName": "ERICA",
    "OtherMiddleName": "DAWN",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "11630 FULTON ST E",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOWELL",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49331-9426",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "616-481-3784",
    "MailingAddressFaxNumber": "866-496-2998",
    "FirstLinePracticeLocationAddress": "11630 FULTON ST E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOWELL",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49331-9426",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "616-481-3784",
    "PracticeLocationAddressFaxNumber": "866-496-2998",
    "EnumerationDate": "01/04/2017",
    "LastUpdateDate": "12/19/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "6401015864",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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