Individual provider Active NPI

Lyndsay Elizabeth Martin, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1295976983
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092941 Issued in MI
Practice address
385 Leonard St NE
Grand Rapids, MI 49503-1129
Phone
(616) 726-5119
Fax
(616) 458-8039
NPI assigned
Mar 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802086432 MI
Clinical Social Worker 1041C0700X 6801092941 MI Primary

Addresses

Primary practice location

385 Leonard St NE
Grand Rapids, MI 49503-1129

Mailing address

385 Leonard St NE
Grand Rapids, MI 49503-1129
Phone (616) 726-5119

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

LicenseStateTypeSpecialty
6802086432MIMDSocial Worker
6801092941MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1295976983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031129",
            "telephone_number": "616-726-5119",
            "fax_number": "616-458-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031129",
            "telephone_number": "616-726-5119",
            "fax_number": "616-458-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LYNDSAY",
        "middle_name": "ELIZABETH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802086432",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.