Lisa Marie Godfrey Martin, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 60253453 Issued in WA

Practice address

206 W 1St Ave
Ellensburg, WA 98926-3002

Phone

(509) 201-1616

Fax

(844) 755-6412

NPI assigned

May 30, 2012

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Psychological Services

  • Psychologist
  • Ellensburg, WA
  • NPI 1356842785
  NPD Authorized official
• Plateau Family Medicine, PS

  • Family Medicine Physician
  • Enumclaw, WA
  • NPI 1033222146
  NPD (past)

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1427319052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1533",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989261908",
            "telephone_number": "509-856-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W 1ST AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263002",
            "telephone_number": "509-201-1616",
            "fax_number": "844-755-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LISA",
        "middle_name": "MARIE GODFREY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 60253453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Main
• James Collins Manson-Hing, M.D.
• Marcia Rorty, PHD, PLLC
• Awjahney Markholt
• Jennifer Nicole Martin, MSN, ARNP
• Meagan Martin
• Areli Martinez-Bustos
• Faith Kaylyn Mason
• Hendrika Mather, M.S.
• Jamie Matson

• Clinical Psychologist in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.