Individual provider Active NPI

Martha Lousia Selph, LMSW

  • Clinical Social Worker
  • Cumming, GA
National Provider Identifier
1023737624
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW010890 Issued in GA
Practice address
1435 Haw Creek Cir Ste 403
Cumming, GA 30041-6567
Phone
(770) 940-9679
NPI assigned
Aug 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW010890 GA
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X MSW010890 GA Primary

Addresses

Primary practice location

1435 Haw Creek Cir Ste 403
Cumming, GA 30041-6567

Mailing address

1435 Haw Creek Cir Ste 403
Cumming, GA 30041-6567
Phone (770) 940-9679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1211 W 22ND St
Suite 406
Oak Brook, IL 60523-2169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW010890GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Live Life Counseling, LLC Clinical CurrentSince Dec 8, 2024 Accepting new patients

Locations

1435 Haw Creek Cir E
Ste 403
Cumming, GA 30041
Phone (678) 834-9274

Organizations & group practices 1

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": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1023737624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 HAW CREEK CIR STE 403",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416567",
            "telephone_number": "770-940-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 HAW CREEK CIR STE 403",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416567",
            "telephone_number": "770-940-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELPH",
        "first_name": "MARTHA",
        "middle_name": "LOUSIA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW010890",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW010890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.