Individual provider Active NPI

Julie A Martin, LCSW

  • Clinical Social Worker
  • Norwich, CT
National Provider Identifier
1003941576
Registry record updated Oct 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007387 Issued in CT
Practice address
47 Town St
Norwich, CT 06360-2315
Phone
(860) 892-7042
Fax
(860) 823-3060
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007387 CT Primary

Addresses

Primary practice location

47 Town St
Norwich, CT 06360-2315

Mailing address

47 Town St
Norwich, CT 06360-2315
Phone (860) 892-7042

Other identifiers 1

IdentifierTypeStateIssuer
004235942MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110128000011 CT Practitioner - Clinical Social Worker 8820277494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Community and Family Services, IncGroup PAC ID 9032012497, 71 clinicians

Practice addresses (Care Compare)

47 Town St
Norwich, CT 06360-2323
Phone (860) 892-7042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007387CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United Community and Family Services, Inc. CurrentSince Jul 25, 2023 Accepting new patients
Orthopedic Physical Therapy of Southern New England LLC Past Accepting new patients
Select Behavioral Health, LLC Clinical PastSince Jan 1, 1999 Accepting new patients

Locations

70 Main St
Jewett City, CT 06351
Phone (860) 376-7040

47 Town St
Norwich, CT 06360

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286755200000",
    "number": "1003941576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602315",
            "telephone_number": "860-892-7042",
            "fax_number": "860-823-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602315",
            "telephone_number": "860-892-7042",
            "fax_number": "860-823-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235942",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.