Individual provider Active NPI

Emily G Martin

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1487205340
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
933 E Columbus Ave
Springfield, MA 01105-2509
Phone
(413) 930-4092
Fax
(413) 846-0447
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW19205 FL
Clinical Social Worker 1041C0700X 14784 CT
Clinical Social Worker 1041C0700X 126733 MA
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

933 E Columbus Ave
Springfield, MA 01105-2509

Mailing address

933 E Columbus Ave
Springfield, MA 01105-2509
Phone (413) 930-4092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231206000002 FL Practitioner - Clinical Social Worker 3577912310 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14784CTMDClinical Social Worker
126733MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Center, Inc. CurrentSince Sep 26, 2023 Accepting new patients

Locations

4024 Central Ave
St Petersburg, FL 33711

928 22nd Ave S
St Petersburg, FL 33705
Phone (727) 327-5676

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1487205340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 E COLUMBUS AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011052509",
            "telephone_number": "413-930-4092",
            "fax_number": "413-846-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 E COLUMBUS AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011052509",
            "telephone_number": "413-930-4092",
            "fax_number": "413-846-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EMILY",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19205",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "14784",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "126733",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.