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KELLY MARTIN
NPI 1639030257
Counselor in Joliet, IL

Active since November 21, 2025PECOS EnrolledAccepts Medicare Assignment
54 N OTTAWA ST STE 245, JOLIET, IL 60432(833) 777-6352 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Martin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY MARTIN (NPI 1639030257) is an individual counselor in Joliet, Illinois and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1639030257
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameKELLY MARTIN
Location Address54 N OTTAWA ST STE 245Joliet, IL 60432-4378
Mailing Address54 N Ottawa St Ste 245Joliet, IL 60432-4378 · (833) 777-6352
Phone(833) 777-6352
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateNovember 21, 2025
NPPES CertifiedNovember 21, 2025
✔ NPI 1639030257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
54 N OTTAWA ST STE 245, Joliet, IL 60432
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Martin is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103311600
PECOS Enrollment IDI20251222003240
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MINDFUL LIVING CENTER ILLINOIS CHICAGO NW LLC
Clinic/Center (Adolescent and Children Mental Health)
54 N OTTAWA ST STE 245
JOLIET, IL 60432
Will County (815) 277-5050
MINDFUL LIVING CENTER ILLINOIS JOLIET LLC
Clinic/Center (Adolescent and Children Mental Health)
54 N OTTAWA ST STE 245
JOLIET, IL 60432
Will County (815) 277-5050
MINDFUL LIVING CENTER - CHICAGO LLC
Clinic/Center (Adolescent and Children Mental Health)
54 N OTTAWA ST STE 245
JOLIET, IL 60432
Will County (833) 777-6352

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Martin's NPI number?

The NPI number for Kelly Martin is 1639030257. It was assigned to this individual provider in the NPPES registry on November 21, 2025.

Where is Kelly Martin located?

Kelly Martin practices at 54 N Ottawa St Ste 245, Joliet, IL 60432. The listed phone number is (833) 777-6352.

What is Kelly Martin's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Kelly Martin enrolled in Medicare?

Yes. Kelly Martin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelly Martin was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.