MR. MARK RANDALL MARTIN L.C.P.C. NPI 1467563205

NPI Information

  • NPI: 1467563205
  • Provider Name: MR. MARK RANDALL MARTIN, L.C.P.C.
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 1505 EASTLAND DR
    EMP II LL 1000
    BLOOMINGTON, IL
    ZIP 61701
  • Phone: (309) 663-1623

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NPI Details

MR. Mark Randall Martin, L.C.P.C. is a professional counselor in Bloomington, IL. MR. Mark Randall Martin, L.C.P.C. NPI is 1467563205. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1505 EASTLAND DR
EMP II LL 1000
BLOOMINGTON, IL
ZIP 61701-534
Phone: (309) 663-1623

The enumeration date for this NPI number is 8/31/2006 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
1101YP2500XCounselorProfessionalILLINOISYes

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: 3/30/2025

NPI Synchronization or Removal

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