Active NPI
Marta Lynn Tilley, LCSW
- Clinical Social Worker
- Orlando, FL
National Provider Identifier
1114229143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 3280
- Practice address
- 10502 Satellite Blvd
Suite D
Orlando, FL 32837-8479 - Phone
- (407) 850-9141
- Fax
- (407) 850-9687
- NPI assigned
- Nov 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 3280 | FL | Primary |
Addresses
Primary practice location
10502 Satellite Blvd
Suite D
Orlando, FL 32837-8479
Mailing address
10502 Satellite Blvd
Suite D
Orlando, FL 32837-8479
Phone (407) 850-9141
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
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 3280 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LDS Family Services | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Orlando, FL
- NPI 1649375650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1114229143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10502 SATELLITE BLVD",
"address_2": "SUITE D",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328378479",
"telephone_number": "407-850-9141",
"fax_number": "407-850-9687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10502 SATELLITE BLVD",
"address_2": "SUITE D",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328378479",
"telephone_number": "407-850-9141",
"fax_number": "407-850-9687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "MARTA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-24",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 3280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.