David Lee Martin, LCSW
Individual provider Active NPI Clinical Social Worker · La Salle, IL
NPI 1154828820 · NPPES record last updated Apr 10, 2018
Key facts
- NPI
- 1154828820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 142.020019 (IL)
- Practice address
- 2960 Chartres St
La Salle, IL 61301-1097 - Phone
- (815) 224-1610
- NPI assigned
- Apr 10, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142.020019 | IL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 142.020019 | IL | Yes |
Addresses
Primary practice location
2960 Chartres St
La Salle, IL 61301-1097
Mailing address
301 E Hopkins Ave
Granville, IL 61326-9616
Phone (815) 224-1610
Other providers in La Salle, IL
- John Phillip Lavieri
- Sarah Lavieri
- Jennifer N Leonard
- Life Balance Counseling and Wellness Inc
- Local NP PC
- Susan May
- Alexis Marie McCoy
- Kimberly Ann Mercer
- MHC Illinois Inc
- Traci Midnight
All providers in La Salle, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.