Madelyne Mildred Martinez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW17998 Issued in AZ

Practice address

2632 E Thomas Rd Ste 101
Phoenix, AZ 85016-8220

Phone

(602) 957-2507

Fax

(602) 957-2510

NPI assigned

Sep 14, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southwest Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1144384389
  Medicare reassignment NPD
• Southwest Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1407165392
  NPD
• Southwest Behavioral Health Services,Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bullhead City, AZ
  • NPI 1093942161
  NPD
• Southwest Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1023023603
  NPD (past)

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1134479397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MOTOR AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90034",
            "telephone_number": "310-836-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 E THOMAS RD STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168220",
            "telephone_number": "602-957-2507",
            "fax_number": "602-957-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MADELYNE",
        "middle_name": "MILDRED",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW17998",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Marie Martinez, PT
• Kathryn Jene Martinez
• Kim Martinez, M.D.
• Korey Martinez, COTA
• Lauren Alexis Martinez, SLPA
• Makayla Rose Martinez
• Malia Martinez, PT, DPT
• Manuela Ramos Martinez, R.N.
• Maria Martinez, M.D.
• Mary Martinez, LCSW

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.