Individual provider Active NPI

Terri Lynn Martinez, LCMSW

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1477047470
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801113522 Issued in MI
Practice address
649 S 8 Mile Rd
Midland, MI 48640-7814
Phone
(989) 948-1354
NPI assigned
Jun 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Clinical Social Worker 1041C0700X 6801113522 MI Primary

Addresses

Primary practice location

649 S 8 Mile Rd
Midland, MI 48640-7814

Mailing address

9901 NE 7TH Ave Ste A206
Vancouver, WA 98685-4526
Phone (369) 718-8636

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

LicenseStateTypeSpecialty
6801113522MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Clinical CurrentSince Nov 29, 2021 Accepting new patients
Eternal Hope Christian Counseling Clinical Past Accepting new patients

Locations

655 E Cedar Ave
Gladwin, MI 48624
Phone (989) 426-9295

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

Organizations & group practices 2

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": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1477047470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 NE 7TH AVE STE A206",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854526",
            "telephone_number": "369-718-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 S 8 MILE RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407814",
            "telephone_number": "989-948-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TERRI",
        "middle_name": "LYNN",
        "credential": "LCMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801113522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.