Individual provider Active NPI

Kay Lynn Marble, LMSW, ACSW, CAC-R

  • Clinical Social Worker
  • Ludington, MI
National Provider Identifier
1194904649
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801083303 Issued in MI
Practice address
106 Franklin St
Ludington, MI 49431-1845
Phone
(231) 233-5657
NPI assigned
Nov 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801083303 MI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 111129 MI

Addresses

Primary practice location

106 Franklin St
Ludington, MI 49431-1845

Mailing address

106 Franklin St
Ludington, MI 49431-1845
Phone (231) 233-5657

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
111129MIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Area Counseling Service, Inc Addiction (Substance Use Disorder) PastSince Jan 29, 2019 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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1194904649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 FRANKLIN ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311845",
            "telephone_number": "231-233-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FRANKLIN ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311845",
            "telephone_number": "231-233-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBLE",
        "first_name": "KAY",
        "middle_name": "LYNN",
        "credential": "LMSW, ACSW, CAC-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801083303",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "111129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.