Active NPI
Angel Lynn Martin, MSW, LCSW
- Clinical Social Worker
- Wright Patterson Afb, OH
National Provider Identifier
1275977936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34006309A
- Practice address
- 4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529 - Phone
- (937) 257-9968
- NPI assigned
- Apr 24, 2013
- 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 | 34006309A | IN | Primary |
Addresses
Primary practice location
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Mailing address
88TH Mdos/Sgomo
4881 Sugar Maple Drive
Wright-Patterson, Afb, OH 45433
Phone (937) 257-9968
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 |
|---|---|---|---|
| 34006309A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522800000000",
"number": "1275977936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88TH MDOS/SGOMO",
"address_2": "4881 SUGAR MAPLE DRIVE",
"city": "WRIGHT-PATTERSON, AFB",
"state": "OH",
"postal_code": "45433",
"telephone_number": "937-257-9968",
"fax_number": "937-257-0450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "WRIGHT PATTERSON AFB",
"state": "OH",
"postal_code": "454335529",
"telephone_number": "937-257-9968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ANGEL",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-24",
"last_updated": "2018-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34006309A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wright Patterson Afb, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.