Organization Active NPI

Lake Martin Family Therapy, LLC

  • Clinical Social Worker
  • Alexander City, AL
National Provider Identifier
1497904312
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2121C Issued in AL
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

Updated by the provider on Sep 16, 2008

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)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 2121C AL Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
L 299OtherALALABAMA BOARD OF EXAMINERS IN MARRIAGE & FAMILY THERAPY
2121COtherALSTATE OF ALABAMA BOARD OF SOCIAL WORK EXMAINERS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.