Individual provider Active NPI

Melanie Martynowski, LSW

  • Social Worker
  • Cleveland, OH
National Provider Identifier
1194239970
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1701217 Issued in OH
Practice address
8411 Broadway Ave
Cleveland, OH 44105-3932
Phone
(216) 441-0200
NPI assigned
Dec 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.161942 OH
Social Worker 104100000X S.1701217 OH Primary

Addresses

Primary practice location

8411 Broadway Ave
Cleveland, OH 44105-3932

Mailing address

4264 W 56TH St
Cleveland, OH 44144-1848
Phone (216) 209-8436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.161942OHMDAddiction (Substance Use Disorder) Counselor
S.1701217OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone Past Accepting new patients

Organizations & group practices 1

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": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1194239970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4264 W 56TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441441848",
            "telephone_number": "216-209-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8411 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441053932",
            "telephone_number": "216-441-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTYNOWSKI",
        "first_name": "MELANIE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-01",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161942",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1701217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.