Ladrena Nicole Martin, SUPERVISEE IN SW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

0906011602 Issued in VA

Practice address

111 Bulifants Blvd
Williamsburg, VA 23188-5711

Phone

(757) 645-3860

NPI assigned

Apr 14, 2022

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

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seaside Wellness, LLC

  • Mental Health Counselor
  • Yorktown, VA
  • NPI 1255026746
  Medicare reassignment NPD

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1316680838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BULIFANTS BLVD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BULIFANTS BLVD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885711",
            "telephone_number": "757-645-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LADRENA",
        "middle_name": "NICOLE",
        "credential": "SUPERVISEE IN SW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0906011602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanford Kent Marcuson, M.D.
• Zantha Christine Marcuson, MD
• Steven C Mares, MD
• Amy Marley - Kennedy, DPT
• Justin Martin
• Tealece Martin
• Aniya Rosa Martinez
• Rey Martinez
• Charles Martino
• Mary Immaculate Hospital

• Social Worker in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.