Active NPI
Shannon Marie Martin, LCSW
- Clinical Social Worker
- Clearwater, FL
National Provider Identifier
1225282908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 9213
- Practice address
- 1437 S Belcher Rd
Clearwater, FL 33764-2829 - Phone
- (727) 524-4464
- NPI assigned
- Nov 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 9213 | FL | Primary |
Addresses
Primary practice location
1437 S Belcher Rd
Clearwater, FL 33764-2829
Mailing address
12818 Coverdale Dr
Tampa, FL 33624-4001
Phone (185) 066-1932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019725600 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW 9213 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1225282908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12818 COVERDALE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336244001",
"telephone_number": "185-066-1932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1437 S BELCHER RD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337642829",
"telephone_number": "727-524-4464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SHANNON",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-08",
"last_updated": "2023-10-18",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 9213",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019725600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.