Active NPI
Olivia Martin, LCSW
- Clinical Social Worker
- Ft Cavazos, TX
National Provider Identifier
1366219529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC22377
- Practice address
- 757 W Legends Way
Ft Cavazos, TX 76544 - Phone
- (254) 553-5720
- NPI assigned
- Dec 7, 2023
- Sex
- Female
- 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 | LC22377 | ME | Primary |
Addresses
Primary practice location
757 W Legends Way
Ft Cavazos, TX 76544
Mailing address
757 W Legends Way
BLDG 24001
Fort Cavazos, TX 76544
Phone (706) 393-0909
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 |
|---|---|---|---|
| LC22377 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701907200000",
"number": "1366219529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "757 W LEGENDS WAY",
"address_2": "BLDG 24001",
"city": "FORT CAVAZOS",
"state": "TX",
"postal_code": "76544",
"telephone_number": "706-393-0909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 W LEGENDS WAY",
"city": "FT CAVAZOS",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-553-5720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "OLIVIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-07",
"last_updated": "2023-12-07",
"certification_date": "2023-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC22377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Cavazos, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.