Individual provider Active NPI

Jessica Afton Martin, LLMSW

  • Clinical Social Worker
  • Okemos, MI
National Provider Identifier
1194331884
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801100393 Issued in MI
Practice address
3899 Okemos Rd Ste A1
Okemos, MI 48864-3666
Phone
(517) 507-5892
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801100393 MI Primary

Addresses

Primary practice location

3899 Okemos Rd Ste A1
Okemos, MI 48864-3666

Mailing address

3899 Okemos Rd Ste A1
Okemos, MI 48864-3666
Phone (517) 507-5892

Other names 1

  • Jessica Afton Root Former name

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
6801100393MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inclusive Wellness LLC Clinical CurrentSince Mar 1, 2021 Accepting new patients
Spring Forest Counseling LLP Single Specialty CurrentSince Sep 18, 2020 Accepting new patients

Locations

3970 Heritage Ave
Okemos, MI 48864
Phone (517) 258-2951

3899 Okemos Rd
Ste A1
Okemos, MI 48864
Phone (517) 395-2260

Organizations & group practices 2

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": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1194331884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3899 OKEMOS RD STE A1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643666",
            "telephone_number": "517-507-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3899 OKEMOS RD STE A1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643666",
            "telephone_number": "517-507-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSICA",
        "middle_name": "AFTON",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ROOT",
            "middle_name": "AFTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.