MR. KENNETH SCOTT MARTIN CADC NPI 1255438362

NPI Information

NPI: 1255438362
Provider Name: MR. KENNETH SCOTT MARTIN, CADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
4940 E STATE ST
ROCKFORD, IL
ZIP 61108
Phone: (815) 227-0081
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MR. Kenneth Scott Martin, CADC is an addiction (substance use disorder) counselor in Rockford, IL. MR. Kenneth Scott Martin, CADC NPI is 1255438362. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4940 E STATE ST
ROCKFORD, IL
ZIP 61108-270
Phone: (815) 227-0081
Fax: (815) 387-5316

The enumeration date for this NPI number is 9/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	13193	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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