Active NPI
Kathleen F Martin, LCSW
- Clinical Social Worker
- The Dalles, OR
National Provider Identifier
1396818258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L3499
- Practice address
- 1700 E 19TH St
The Dalles, OR 97058-3317 - Phone
- (541) 296-7760
- Fax
- (541) 296-7619
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- 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 | L3499 | OR | Primary |
Addresses
Primary practice location
1700 E 19TH St
The Dalles, OR 97058-3317
Mailing address
1700 E 19TH St
The Dalles, OR 97058-3317
Phone (541) 296-7760
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 |
|---|---|---|---|
| L3499 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Columbia Medical Center | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1396818258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 E 19TH ST",
"city": "THE DALLES",
"state": "OR",
"postal_code": "970583317",
"telephone_number": "541-296-7760",
"fax_number": "541-296-7619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E 19TH ST",
"city": "THE DALLES",
"state": "OR",
"postal_code": "970583317",
"telephone_number": "541-296-7760",
"fax_number": "541-296-7619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KATHLEEN",
"middle_name": "F",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L3499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Dalles, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.