Individual provider Active NPI

Amber Shea Martin, LCSW

  • Clinical Social Worker
  • Conroe, TX
National Provider Identifier
1164261640
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104140 Issued in TX
Practice address
9529 Chasewood Blvd
Conroe, TX 77304-7403
Phone
(480) 570-4785
NPI assigned
May 23, 2024
Last updated
May 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104140 TX Primary

Addresses

Primary practice location

9529 Chasewood Blvd
Conroe, TX 77304-7403

Mailing address

9529 Chasewood Blvd
Conroe, TX 77304-7403
Phone (480) 570-4785

Other names 1

  • Amber Shea Pierce Former name

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104140TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1164261640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9529 CHASEWOOD BLVD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773047403",
            "telephone_number": "480-570-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9529 CHASEWOOD BLVD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773047403",
            "telephone_number": "480-570-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMBER",
        "middle_name": "SHEA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "PIERCE",
            "middle_name": "SHEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.