DR. TRISTAN KAREL MARTIN (NPI# 1275009995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275009995 |
| Entity Type | Individual |
| Full Name | DR. TRISTAN KAREL MARTIN |
| Credential | PH.D.,LMFT |
| Practice Address |
4500 Pewter Lane 8&9 Manlius NY 13104 |
| Mailing Address |
792 N Main St Syracuse NY 13212-1644 |
| Practice Telephone | 3152996975 |
| Mailing Telephone | 3152996975 |
| Enumeration Date | 2018-10-20 |
| Last Update Date | 2020-03-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 001640 | NY | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | P10033 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902044761 | Tristan Vittorio Martin | Dentist | 17130 Sw Upper Boones Ferry Rd, Portland, OR 97224-7004 | 2009-01-30 |
| Street Address |
4500 PEWTER LANE 8&9 |
| City | MANLIUS |
| State | NY |
| Zip Code | 13104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334423 | Cindy Gleason | Technician | 8450 Number 2 Rd East, Manlius, NY 13104 | 2019-09-05 |
| 1184141715 | Walgreen Co | Pharmacy | 315 Fayette St Ste 3, Manlius, NY 13104 | 2017-08-24 |
| 1518233386 | Edward Theodore Schroeder | Internal Medicine | 8345 Vassar Drive, Manlius, NY 13104 | 2012-03-27 |
| 1790052017 | Megan Lynn Perioli | Counselor | 8219 Market Pl Bldg 10, Manlius, NY 13104 | 2011-12-01 |
| 1194979088 | Erin Elizabeth Kolceski | Speech-Language Pathologist | 8141 Old Sunridge Dr, Manlius, NY 13104 | 2008-11-05 |
| 1700037314 | Peter H Emery Jr. | Pharmacist | 3215 Pompey Center Road, Manlius, NY 13104 | 2008-10-02 |
| 1093987216 | Jason David Henderson | Dentist | 8179 Cazenovia Rd., Manlius, NY 13104 | 2008-03-27 |
| 1154517019 | Cynthia E Cavanaugh | Registered Nurse | 2968 Gulf Rd, Manlius, NY 13104 | 2007-09-24 |
| 1487853537 | Harold Jason Rodman | Dentist | 28 Lincklaen St, Cazenovia, NY 13104 | 2007-07-17 |
| 1033325253 | Geraldine Mary Dicosimo | Nurse Practitioner | 8112 Cazenovia Road, Seven Pines Office Bldg. One, Suite 3, Manlius, NY 13104 | 2007-05-15 |
| Find all providers in zip 13104 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760525588 | Jane Louise William | Marriage & Family Therapist | 110 Edwards Falls Ln, Manlius, NY 13104-8349 | 2007-02-14 |
| 1164054060 | Jennifer Lauren Coppola | Marriage & Family Therapist | 4500 Pewter Ln # 89, Manlius, NY 13104-9707 | 2020-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649146 | Cosmic Psych-medx | Marriage & Family Therapist | 2065 E 54th St Apt 2, Brooklyn, NY 11234-4750 | 2020-11-06 |
| 1093316309 | Jessica Janik | Marriage & Family Therapist | 625 Panorama Trl Ste 220, Rochester, NY 14625-2432 | 2020-11-03 |
| 1528666054 | Esther Mann | Marriage & Family Therapist | 1226 W Broadway # L-2, Hewlett, NY 11557-1923 | 2020-10-16 |
| 1205434883 | Rachel Davies | Marriage & Family Therapist | 8641 Cobalt Dr, Cicero, NY 13039-8943 | 2020-10-15 |
| 1669079935 | Tiffany Sheppard | Marriage & Family Therapist | 1057 Boynton Ave Apt 2a, Bronx, NY 10472-5761 | 2020-10-08 |
| 1528665205 | Aurela Gjura | Marriage & Family Therapist | 432 E 149th St Fl 3, Bronx, NY 10455-1343 | 2020-10-06 |
| 1326645920 | Oksana Isakharov | Marriage & Family Therapist | Remote Telehealth Due To Pandemic, Remote Telehealth Due To Pandemic, NY 11040 | 2020-10-06 |
| 1265039168 | Christina Berdebes | Marriage & Family Therapist | 11123 76th Rd Apt C5, Forest Hills, NY 11375-6434 | 2020-10-04 |
| 1144827122 | Rachel Kinsella | Marriage & Family Therapist | 141 W 26th St Apt 4b, New York, NY 10001-6800 | 2020-10-03 |
| 1720695554 | Katie Lynn Helpley Marriage & Family Therapist Pllc | Marriage & Family Therapist | 550 Stony Brook Ct Ste 3, Newburgh, NY 12550-6557 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
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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.