NPIMap

Organization Active NPI

Elaine Martin, Licsw, LLC

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1255732111
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000638ISW Issued in RI
Legal business name
ELAINE MARTIN, LICSW, LLC
Practice address
120 Wayland Ave
Suite 1
Providence, RI 02906-4318
Phone
(401) 354-9372
Fax
(401) 709-3776
NPI assigned
Sep 10, 2014
Last updated
Sep 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Authorized official

Name
Elaine Louise Martin, LICSWNPI 1639187461
Title
Sole Member
Phone
(401) 354-9372

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 000638ISW RI Primary

Addresses

Primary practice location

120 Wayland Ave
Suite 1
Providence, RI 02906-4318

Mailing address

39 Townsend St
Barrington, RI 02806-1417
Phone (401) 354-9372

National Provider Directory

National Provider Directory

Locations

1 Richmond Sq
Ste 232E
Providence, RI 02906
Phone (401) 354-9372

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1255732111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 TOWNSEND ST",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028061417",
            "telephone_number": "401-354-9372",
            "fax_number": "401-709-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WAYLAND AVE",
            "address_2": "SUITE 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064318",
            "telephone_number": "401-354-9372",
            "fax_number": "401-709-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELAINE MARTIN, LICSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "401-354-9372",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "000638ISW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.