Organization Active NPI

Kathleen S. Martin, MSW, LCSW,Inc.

  • Clinical Social Worker
  • Palm Beach Gardens, FL
National Provider Identifier
1215316286
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6384 Issued in FL
Legal business name
KATHLEEN S. MARTIN, MSW, LCSW,INC.
Practice address
3307 Northlake Blvd # B104
B104
Palm Beach Gardens, FL 33403-1703
Phone
(561) 694-5265
NPI assigned
May 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Authorized official

Name
Kathleen Stonebrink Martin, LCSWNPI 1881737732
Title
Owner
Phone
(561) 694-5265

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW6384 FL Primary

Addresses

Primary practice location

3307 Northlake Blvd # B104
B104
Palm Beach Gardens, FL 33403-1703

Mailing address

3307 Northlake Blvd # B1O4
B104
Palm Beach Gardens, FL 33403-1703
Phone (561) 694-5265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160615002484 FL Part B Supplier - Clinic/Group Practice 4981995354 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Locations

3307 Northlake Blvd
#B104B104
Palm Beach Gardens, FL 33403
Phone (561) 694-5265

3307 Northlake Blvd
#B1O4B104
Palm Beach Gardens, FL 33403

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1215316286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 NORTHLAKE BLVD # B1O4",
            "address_2": "B104",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031703",
            "telephone_number": "561-694-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 NORTHLAKE BLVD # B104",
            "address_2": "B104",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031703",
            "telephone_number": "561-694-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN S. MARTIN, MSW, LCSW,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-24",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "STONEBRINK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-694-5265",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.