Active NPI
C Kai Medina Martinez, LCSW
- Clinical Social Worker
- Brigham City, UT
National Provider Identifier
1326102310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 310922-3501
- Practice address
- 33 S Main St # 2a
Brigham City, UT 84302-2668 - Phone
- (801) 467-2072
- NPI assigned
- Dec 21, 2006
- Sex
- Male
- 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 | 310922-3501 | UT | Primary |
Addresses
Primary practice location
33 S Main St # 2a
Brigham City, UT 84302-2668
Mailing address
33 S Main St # 2a
Brigham City, UT 84302-2668
Phone (801) 556-7762
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 |
|---|---|---|---|
| 310922-3501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inner Traditions Counseling Services | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Salt Lake City, UT
- NPI 1194895136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1326102310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 S MAIN ST # 2A",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843022668",
"telephone_number": "801-556-7762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 S MAIN ST # 2A",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843022668",
"telephone_number": "801-467-2072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA MARTINEZ",
"first_name": "C KAI",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2024-08-15",
"certification_date": "2024-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "310922-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brigham City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.