Individual provider Active NPI

Emily K Martin, LCSW

  • Clinical Social Worker
  • Chesterfield, VA
National Provider Identifier
1184895344
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006545 Issued in VA
Practice address
6801 Lucy Corr CT
Chesterfield, VA 23832-6657
Phone
(804) 748-1227
Fax
(804) 717-6659
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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 0904006545 VA Primary

Addresses

Primary practice location

6801 Lucy Corr CT
Chesterfield, VA 23832-6657

Mailing address

6801 Lucy Corr CT
Chesterfield, VA 23832-6657
Phone (804) 748-1227

Other identifiers 1

IdentifierTypeStateIssuer
004945352MedicaidVA

Other names 1

  • Ms. Emily K Kennedy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 18, 2024 through Sep 18, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904011811VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Old Towne Counseling Services, LLC PastSince Mar 30, 2014 Accepting new patients
Chesterfield County Mental Health Past Accepting new patients
Chesterfield County Mental Health Past Accepting new patients

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": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1184895344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LUCY CORR CT",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-748-1227",
            "fax_number": "804-717-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LUCY CORR CT",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-748-1227",
            "fax_number": "804-717-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EMILY",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945352",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KENNEDY",
            "middle_name": "K",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.