Active NPI
Lake Martin Family Therapy, LLC
- Clinical Social Worker
- Alexander City, AL
National Provider Identifier
1497904312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2121C
- Legal business name
- LAKE MARTIN FAMILY THERAPY, LLC
- Practice address
- 393 Green St
Alexander City, AL 35010-1407 - Phone
- (256) 625-9514
- Fax
- (256) 825-6418
- NPI assigned
- Sep 16, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karen C. Lewis, LMFT, LCSW
- Title
- Member/Owner
- Phone
- (256) 625-9514
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2121C | AL | Primary |
| Marriage & Family Therapist | 106H00000X | L 299 | AL |
Addresses
Primary practice location
393 Green St
Alexander City, AL 35010-1407
Mailing address
PO Box 911
Alexander City, AL 35011-0911
Phone (256) 625-9514
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L 299 | Other | AL | ALABAMA BOARD OF EXAMINERS IN MARRIAGE & FAMILY THERAPY |
| 2121C | Other | AL | STATE OF ALABAMA BOARD OF SOCIAL WORK EXMAINERS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Alexander City, AL
- NPI 1760728877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1221523200000",
"number": "1497904312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 911",
"city": "ALEXANDER CITY",
"state": "AL",
"postal_code": "350110911",
"telephone_number": "256-625-9514",
"fax_number": "256-825-6418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 GREEN ST",
"city": "ALEXANDER CITY",
"state": "AL",
"postal_code": "350101407",
"telephone_number": "256-625-9514",
"fax_number": "256-825-6418"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE MARTIN FAMILY THERAPY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-16",
"last_updated": "2008-09-16",
"status": "A",
"authorized_official_last_name": "LEWIS",
"authorized_official_first_name": "KAREN",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "MEMBER/OWNER",
"authorized_official_telephone_number": "256-625-9514",
"authorized_official_credential": "LMFT, LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "AL",
"license": "2121C",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "AL",
"license": "L 299",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALABAMA BOARD OF EXAMINERS IN MARRIAGE & FAMILY THERAPY",
"identifier": "L 299",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF ALABAMA BOARD OF SOCIAL WORK EXMAINERS",
"identifier": "2121C",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Alexander City, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.