Lise Martin, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6582 Issued in MA

Practice address

70 Washington St
Suite 320
Salem, MA 01970-3518

Phone

(978) 741-7890

Fax

(978) 741-7890

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Daniel Rutrick MD PC

  • Adult Psychiatric/Mental Health Registered Nurse
  • Everett, MA
  • NPI 1851500151
  NPD (past)
• Daniel Rutrick, MD, PC

  • Prescribing (Medical) Psychologist
  • Everett, MA
  • NPI 1336341502
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1083725766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST",
            "address_2": "SUITE 320",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703518",
            "telephone_number": "978-741-7890",
            "fax_number": "978-741-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST",
            "address_2": "SUITE 320",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703518",
            "telephone_number": "978-741-7890",
            "fax_number": "978-741-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LISE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDEX BC",
            "identifier": "762170",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "Y62170",
            "identifier": "1083725766",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Marrocco, MS
• Bonnie R Martin, R.D.
• Carolyn Brett Martin
• Evalynne Kay Martin, M. A.
• Kellie Marie Martin
• Alexis Martinez
• Louise Virginia Martinez
• Cilomar Martins de Oliveira Filho, MD
• Jennifer Martins, PHARMD
• Mary K Doherty Licsw& Maura Pilotte Licsw Counseling LLC

• Clinical Psychologist in Salem, MA
• Providers in Salem, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.