Active NPI
Anna Kimberly Martin, LCSW
- Clinical Social Worker
- Fairfield, CT
National Provider Identifier
1194976373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8176
- Practice address
- 65 Moody Ave
Fairfield, CT 06825-1924 - Phone
- (203) 339-1465
- NPI assigned
- Oct 6, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089241 | NY | |
| Clinical Social Worker | 1041C0700X | 8176 | CT | Primary |
Addresses
Primary practice location
65 Moody Ave
Fairfield, CT 06825-1924
Mailing address
65 Moody Ave
Fairfield, CT 06825-1924
Phone (203) 339-1465
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8176 | CT | MD | Social Worker |
| 089241 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779840000000",
"number": "1194976373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 MOODY AVE",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068251924",
"telephone_number": "203-339-1465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 MOODY AVE",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068251924",
"telephone_number": "203-339-1465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ANNA",
"middle_name": "KIMBERLY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-06",
"last_updated": "2026-05-27",
"certification_date": "2026-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "089241",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "8176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.