NPIMap

Individual provider Active NPI

Richard William Martin, LICSW

  • Clinical Social Worker
  • Southborough, MA
National Provider Identifier
1417229667
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106343 Issued in MA
Practice address
33 Turnpike Rd
Southborough, MA 01772-2108
Phone
(508) 481-1015
Fax
(508) 485-3421
NPI assigned
Feb 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 106343 MA Primary

Addresses

Primary practice location

33 Turnpike Rd
Southborough, MA 01772-2108

Mailing address

33 Turnpike Rd
Southborough, MA 01772-2108
Phone (508) 481-1015

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

LicenseStateTypeSpecialty
106343MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The New England Center for Children, Inc. 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": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1417229667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 TURNPIKE RD",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017722108",
            "telephone_number": "508-481-1015",
            "fax_number": "508-485-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 TURNPIKE RD",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017722108",
            "telephone_number": "508-481-1015",
            "fax_number": "508-485-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RICHARD",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.