Active NPI
Martin Trevino, LCSW, LCDC
- Clinical Social Worker
- Sheppard Afb, TX
National Provider Identifier
1326224023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 53593
- Practice address
- 527 Tuskegee Airmen Ave
Sheppard Afb, TX 76311 - Phone
- (940) 676-1103
- NPI assigned
- Jan 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10541 | TX | |
| Clinical Social Worker | 1041C0700X | 53593 | TX | Primary |
Addresses
Primary practice location
527 Tuskegee Airmen Ave
Sheppard Afb, TX 76311
Mailing address
82D Med Group
527 Tuskegee Airmen Ave
Sheppard Afb, TX 76311-3430
Phone (940) 676-1103
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 |
|---|---|---|---|
| 10541 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 53593 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694649600000",
"number": "1326224023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82D MED GROUP",
"address_2": "527 TUSKEGEE AIRMEN AVE",
"city": "SHEPPARD AFB",
"state": "TX",
"postal_code": "763113430",
"telephone_number": "940-676-1103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 TUSKEGEE AIRMEN AVE",
"city": "SHEPPARD AFB",
"state": "TX",
"postal_code": "76311",
"telephone_number": "940-676-1103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREVINO",
"first_name": "MARTIN",
"credential": "LCSW, LCDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-14",
"last_updated": "2023-09-14",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "10541",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "53593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheppard Afb, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.