Individual provider Active NPI

Kathy Ann Martin, LMSW

  • Social Worker
  • Poteau, OK
National Provider Identifier
1174874077
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
3640 Issued in OK
Practice address
204 Wall St
Suite a
Poteau, OK 74953-4400
Phone
(918) 647-2155
Fax
(918) 647-4095
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 3640 OK Primary

Addresses

Primary practice location

204 Wall St
Suite a
Poteau, OK 74953-4400

Mailing address

PO Box 179
Stigler, OK 74462-0179
Phone (918) 967-3368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180817001148 OK Practitioner - Clinical Social Worker 8820347206 Reassigns benefits to 2 organizations
I20250207002608 AR Practitioner - Clinical Social Worker 8820347206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Psych Care of Arkansas PAGroup PAC ID 8820474661, 42 clinicians
New Hope Counseling and Guidance Center LLCGroup PAC ID 6608272562, 6 clinicians

Practice addresses (Care Compare)

11503 Rocky Valley Dr
Little Rock, AR 72212-3035
Phone (866) 708-1240

204 Wall St
Poteau, OK 74953-4400
Phone (918) 649-0018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3640OKMDOral and Maxillofacial Surgery (Dentist)
5265OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Feb 10, 2026 Accepting new patients
New Hope Counseling and Guidance Center LLC CurrentSince Aug 26, 2021 Accepting new patients
Supportive Psych Care of Arkansas PA CurrentSince Feb 1, 2025 Accepting new patients

Locations

811 W Elgin St
Siloam Springs, AR 72761
Phone (479) 524-3128

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

101 Park Ave
Oklahoma City, OK 73102
Phone (405) 442-4940

204 Wall St
Ste A
Poteau, OK 74953
Phone (918) 647-2155

204 Wall St
Poteau, OK 74953
Phone (918) 647-8635

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1174874077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744620179",
            "telephone_number": "918-967-3368",
            "fax_number": "918-967-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 WALL ST",
            "address_2": "SUITE A",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534400",
            "telephone_number": "918-647-2155",
            "fax_number": "918-647-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KATHY",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "3640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

Verify at the official NPI Registry.