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1184146235 NPI number — INGRID MARTIN

NPI Number: 1184146235
Health Care Provider/Practitioner: INGRID MARTIN

Information about “1184146235” NPI (INGRID MARTIN) exists in 1184146235 in HTML format HTML  |  1184146235 in plain Text format TXT  |  1184146235 in PDF (Portable Document Format) PDF  |  1184146235 in an XML format XML  formats.

NPI Number : 1184146235 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184146235",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARTIN",
    "FirstName": "INGRID",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "815 FERGUSON RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MINERAL WELLS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76067-8290",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "954-907-0803",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "119 N MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WEATHERFORD",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76086-3257",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "954-907-0803",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/11/2017",
    "LastUpdateDate": "05/01/2025",
    "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": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "81477",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "MH16224",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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