Active NPI
Thomas Edward Martin, LCSW
- Clinical Social Worker
- Wyckoff, NJ
National Provider Identifier
1346340288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC04588400
- Practice address
- 301 Sicomac Ave
Wyckoff, NJ 07481-2159 - Phone
- (201) 848-5800
- Fax
- (201) 848-5493
- NPI assigned
- Sep 22, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC04588400 | NJ | Primary |
Addresses
Primary practice location
301 Sicomac Ave
Wyckoff, NJ 07481-2159
Mailing address
16 Charles Ter
Waldwick, NJ 07463-2014
Phone (201) 670-9749
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC04588400 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346340288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 CHARLES TER",
"city": "WALDWICK",
"state": "NJ",
"postal_code": "074632014",
"telephone_number": "201-670-9749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 SICOMAC AVE",
"city": "WYCKOFF",
"state": "NJ",
"postal_code": "074812159",
"telephone_number": "201-848-5800",
"fax_number": "201-848-5493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "THOMAS",
"middle_name": "EDWARD",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC04588400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyckoff, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.