Malissa Denae Martin, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

MSW010826 Issued in GA

Practice address

39 Flanders Street
Wrightsville, GA 31096

Phone

(478) 247-9553

NPI assigned

Apr 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Malissa D Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1316635188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FLANDERS STREET",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "31096",
            "telephone_number": "478-247-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FLANDERS STREET",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "31096",
            "telephone_number": "478-247-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MALISSA",
        "middle_name": "DENAE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW010826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALISSA",
            "last_name": "MARTIN",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Johnson County Center for Community Health
• Johnson County Commissioner of Roads and Revenues
• Kathryn Johnson, LCSW
• Melissa Cheryl Kilgore, FNP-C
• Allison Lee, PHARMD
• Travis Lamar McClendon
• Clay Richard Mekelburg
• Samuel H Muller, PA
• Nightingale Hospice, Inc.
• Susan Keyton Oliver, NP-C

• All providers in Wrightsville, GA
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.

Verify at the official NPI Registry.