Individual provider Active NPI

Raymond C. Martin, MA LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1205016185
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801009669 Issued in MI
Practice address
18090 Wildemere St
Detroit, MI 48221-2729
Phone
(313) 247-6080
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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 6801009669 MI Primary

Addresses

Primary practice location

18090 Wildemere St
Detroit, MI 48221-2729

Mailing address

18090 Wildemere St
Detroit, MI 48221-2729
Phone (313) 247-6080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110805000440 MI Practitioner - Clinical Social Worker 2769651843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Conversion Contracting LLC CurrentSince Nov 1, 2023 Accepting new patients
Conversion Contracting LLC Clinical PastSince Jun 27, 2016 Accepting new patients
Build a Care Services Inc Clinical PastSince Jun 1, 2025 Accepting new patients

Locations

20131 James Couzens Fwy
Detroit, MI 48235
Phone (313) 445-4765

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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1205016185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18090 WILDEMERE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212729",
            "telephone_number": "313-247-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18090 WILDEMERE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212729",
            "telephone_number": "313-247-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RAYMOND",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "MA LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801009669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.