MR. JEFFREY MARTIN (NPI# 1710145743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710145743 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY MARTIN |
| Credential | LCSW |
| Practice Address |
5804 Elaine Dr Rockford IL 61108-2435 |
| Practice Telephone | 8153977654 |
| Practice Fax Number | 8153972712 |
| Mailing Telephone | 8153977654 |
| Mailing Fax Number | 8153972712 |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
149003373 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164085296 | Jeffrey Martin | Specialist | 8876 Vintage Park Dr # 1158876, Sacramento, CA 95828-5893 | 2019-04-15 |
| 1508281064 | Jeffrey Steven Martin | Psychologist | 300 Palmer Ln, Charlotte, VT 05445-4410 | 2014-02-20 |
| 1467887588 | Jeffrey G Martin | Licensed Practical Nurse | 55 Caroline St, Albion, NY 14411-1020 | 2013-09-09 |
| 1285072074 | Jeffrey Eugene Martin | Physical Therapist | 10415 Lackman Rd, Lenexa, KS 66219-1221 | 2013-06-13 |
| 1720303571 | Jeffrey B Martin | Dentist | 825 Twelve Bridges Dr, Suite 55, Lincoln, CA 95648-8813 | 2010-04-05 |
| 1871725812 | Jeffrey Martin | Dentist | 1960 25th Ave Ste 101, Vero Beach, FL 32960-3015 | 2009-08-10 |
| 1740303445 | Jeffrey Todd Martin | Dentist | 2700 Coltsgate Rd., Ste. #100, Charlotte, NC 28211-3799 | 2007-04-09 |
| 1518081058 | Jeffrey Fred Martin | Optometrist | 2644 E Broadway Blvd, Tucson, AZ 85716-5306 | 2007-03-19 |
| 1407988645 | Jeffrey Ulmer Martin | Dentist | 6 N Lexington Ave, Havertown, PA 19083-5002 | 2007-03-12 |
| 1952446080 | Jeffrey Dean Martin | Family Medicine | North Carolina Disability Determination Services, 3301 Terminal Dr, Raleigh, NC 27602-0243 | 2007-02-20 |
| Street Address |
5804 ELAINE DR |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851433254 | Kathleen Marie Freeburg | Marriage & Family Therapist | 5804 Elaine Dr, Mathers Clinic, Rockford, IL 61108 | 2007-02-13 |
| 1689832693 | Norman H Pfile | Counselor | 5804 Elaine Dr, Rockford, IL 61108 | 2008-05-27 |
| 1700044724 | Anne Ellen De Verneuil | Counselor | 5804 Elaine Dr, Rockford, IL 61108-2435 | 2008-05-27 |
| 1215194519 | Mathers Clinic, LLC | Psychiatry & Neurology | 5804 Elaine Dr, Rockford, IL 61108-2435 | 2008-05-22 |
| 1942492517 | Charles Doy Dudley | Counselor | 5804 Elaine Dr, Rockford, IL 61108-2435 | 2007-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536406 | Jennifer Amy Stone | Counselor | 4433 Hillrise Ct Ne, Rockford, MI 49341-9651 | 2020-07-23 |
| 1992346605 | Cara Kimble | Counselor | 308 W State St Ste 250, Rockford, IL 61101-1140 | 2019-10-03 |
| 1932753258 | Dimensions of Wellness and Transformation, Inc | Counselor | 3701 E State St Ste H, Rockford, IL 61108-1975 | 2019-07-25 |
| 1871094870 | Rachel Schultz | Counselor | 1639 N Alpine Rd Ste 403, Rockford, IL 61107-1440 | 2018-02-24 |
| 1669987806 | Jilian Santander Rakow | Counselor | 10525 Edgerton Ave Ne, Rockford, MI 49341-9120 | 2017-12-11 |
| 1184072126 | Carlton Martin | Counselor | 5896 Creekside Ln, Rockford, IL 61114-6466 | 2016-06-01 |
| 1003273830 | Darcy Krause | Counselor | 6556 Bella Vista Dr Ne, 26 N Main St, Rockford, MI 49341-7861 | 2016-01-25 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1003283169 | Bren Shantz | Counselor | 4890 11 Mile Rd Ne, Rockford, MI 49341-8477 | 2015-08-25 |
| 1710371406 | Rebecca Gielow | Counselor | 2518 Whitmire Dr, Rockford, IL 61109-6732 | 2015-03-20 |
| Find all providers in ROCKFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.