Tanita Martin-Thames, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7489 Issued in MS

Practice address

2637 Ridgewood Rd Ste G
Jackson, MS 39216-4971

Phone

(913) 915-6236

NPI assigned

Mar 5, 2014

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Preferred PHP LLC

  • Psychiatric Hospital
  • Jackson, MS
  • NPI 1225611528
  NPD (past)

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1336565035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2358",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390602358",
            "telephone_number": "913-915-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 RIDGEWOOD RD STE G",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164971",
            "telephone_number": "913-915-6236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "39056",
            "country_code": "US",
            "telephone_number": "601-473-6311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN-THAMES",
        "first_name": "TANITA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malik Marshall
• Martez Antonio Johnson
• Brittney L Martin CPSS
• Martin Solution
• Zipora Martin-Brown, FNP-C
• Adrinnie M Martin
• Alyssa Martin, DO
• Barbara Boss Martin, LPC LMFT
• Bradford Steele Martin, FNP-C
• Brittany Mitchell Martin, MD

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.