Active NPI
Kidian Martinez, LCSW
- Social Worker
- Wilmington, DE
National Provider Identifier
1477068187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- Q1-0001583
- Practice address
- 1600 Rockland Rd
Wilmington, DE 19803-3607 - Phone
- (302) 651-4000
- Fax
- (302) 651-4945
- NPI assigned
- Dec 5, 2017
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Q1-0001583 | DE | Primary |
Addresses
Primary practice location
1600 Rockland Rd
Wilmington, DE 19803-3607
Mailing address
PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-4000
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 |
|---|---|---|---|
| Q1-0001583 | DE | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness Recovery | Current | 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.
-
- Community/Behavioral Health Agency
- Middletown, DE
- NPI 1154063733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512432000000",
"number": "1477068187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-4000",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 ROCKLAND RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198033607",
"telephone_number": "302-651-4000",
"fax_number": "302-651-4945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "KIDIAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-05",
"last_updated": "2017-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "DE",
"license": "Q1-0001583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.