DERRICE LAMONTE MARTIN (NPI# 1780108043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780108043 |
| Entity Type | Individual |
| Full Name | DERRICE LAMONTE MARTIN |
| Credential | RECOVERY COACH |
| Practice Address |
901 Chippewa St Flint MI 48503-1552 |
| Mailing Address |
901 Chippewa Flint MI 48503 |
| Practice Telephone | 8102329950 |
| Practice Fax Number | 8102327599 |
| Mailing Telephone | 8102329950 |
| Mailing Fax Number | 8102327599 |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2017-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NA | 05 |
| Street Address |
901 CHIPPEWA ST |
| City | FLINT |
| State | MI |
| Zip Code | 48503-1552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801819149 | Catholic Charities of Shiawassee and Genesee Counties | Counselor | 901 Chippewa St, Flint, MI 48503-1570 | 2006-07-26 |
| 1093312597 | Megan Rachael Moreno | Social Worker | 901 Chippewa St, Flint, MI 48503-1552 | 2020-10-07 |
| 1194336362 | Tiffany Therese Snay | Counselor | 901 Chippewa St, Flint, MI 48503-1552 | 2020-08-12 |
| 1487287504 | Tammy M Thompson | Counselor | 901 Chippewa St, Flint, MI 48503-1552 | 2020-02-17 |
| 1609409994 | Joshua J Shilling | Peer Specialist | 901 Chippewa St, Flint, MI 48503-1552 | 2020-02-15 |
| 1487209581 | Monkeida Phalet Relerford | Student in an Organized Health Care Education/Training Program | 901 Chippewa St, Flint, MI 48503-1552 | 2019-08-06 |
| 1518439975 | Joshua Aaron Katchka | Community Health Worker | 901 Chippewa St, Flint, MI 48503-1552 | 2018-12-26 |
| 1962984583 | Kelvin Mcdonald | Counselor | 901 Chippewa St, Flint, MI 48503-1552 | 2018-08-30 |
| 1689155590 | Catholic Charities of Shiawassee and Genesee Counties | Counselor | 901 Chippewa St, Flint, MI 48503-1552 | 2018-08-28 |
| 1710487749 | Toni Irene' Harris | Social Worker | 901 Chippewa St, Flint, MI 48503-1552 | 2018-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457971640 | Flint Odyssey House Inc. | Community/Behavioral Health | 1219 Martin Luther King Avenue, Flint, MI 48503 | 2020-04-17 |
| 1891265476 | Mary Margaret Woodruff | Health Educator | 411 E. Third St Suite 2, Flint, MI 48503 | 2018-11-27 |
| 1669942223 | Donna Jean Phelps | Behavior Technician | 2284 S Ballenger Highway, Flint, MI 48503 | 2018-11-27 |
| 1588150601 | Dayonna Scott | Social Worker | Hope Network, 2830 Corunna Rd, Flint, MI 48503 | 2018-07-02 |
| 1801388020 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2284 S Ballenger Hwy Ste F, Flint, MI 48503 | 2018-06-04 |
| 1134610504 | Swathi Gorle | Student in an Organized Health Care Education/Training Program | Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503 | 2018-05-22 |
| 1881128049 | Kara Garr | Registered Nurse | 805 Tuuri Pl, Flint, MI 48503 | 2017-04-14 |
| 1518405638 | Thomasinia Terrell | Peer Specialist | 422 W Fourth Ave, Flint, MI 48503 | 2017-02-09 |
| 1790231041 | Roslyn Boyce | Technician, Other | 2213 E. Court Street, Flint, MI 48503 | 2016-08-28 |
| 1689120818 | Yasmine Elhefnawy | Student in an Organized Health Care Education/Training Program | One Hurley Plaza 3d West, Flint, MI 48503 | 2016-08-28 |
| Find all providers in zip 48503 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003453267 | Patricia Ann Love | Peer Specialist | Training& Treatment Innovations,inc, 929 Stevenson St, Flint, MI 48502 | 2019-12-06 |
| 1851861447 | Mia Riggs | Peer Specialist | 932 Beach St., Flint, MI 48502 | 2018-11-27 |
| 1952870263 | Joshua Enrique Gonzalez | Peer Specialist | 1320 Martin Luther King Ave, Flint, MI 48503-1448 | 2018-11-15 |
| 1518405638 | Thomasinia Terrell | Peer Specialist | 422 W Fourth Ave, Flint, MI 48503 | 2017-02-09 |
| 1033717871 | Stephanie Creel | Peer Specialist | 765 E Hamilton Ave, Flint, MI 48505-4707 | 2020-10-14 |
| 1932706348 | Sara Vanessa Williams | Peer Specialist | 765 E Hamilton Ave, Flint, MI 48505-4707 | 2020-10-08 |
| 1073126116 | Vederia L Jenkins | Peer Specialist | 765 E Hamilton Ave, Flint, MI 48505-4707 | 2020-08-28 |
| 1649880246 | Meghan Peake | Peer Specialist | 529 Martin Luther King Blvd, Flint, MI 48502-2002 | 2020-08-07 |
| 1265042857 | Dana Witzka | Peer Specialist | 529 Martin Luther King Blvd, Flint, MI 48502-2002 | 2020-08-07 |
| 1558971143 | Raina Patterson | Peer Specialist | 529 Martin Luther King Blvd, Flint, MI 48502-2002 | 2020-08-07 |
| Find all providers in FLINT | ||||
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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.