Individual provider Active NPI

Laurie Ellen Martin, LCSW

  • Clinical Social Worker
  • Highland Park, NJ
National Provider Identifier
1508082496
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW44SC00261300 Issued in NJ
Practice address
10 North Second Avenue
Highland Park, NJ 08904
Phone
(732) 565-9812
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW44SC00261300 NJ Primary

Addresses

Primary practice location

10 North Second Avenue
Highland Park, NJ 08904

Mailing address

24 Sage Court
Princeton, NJ 08540
Phone (732) 438-1533

Other identifiers 1

IdentifierTypeStateIssuer
2030811OtherNJCIGNA BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050408000036 NJ Practitioner - Clinical Social Worker 9739136029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4 Tuscany Dr
West Windsor, NJ 08550-2472
Phone (732) 565-9812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW44SC00261300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Laurie E. Martin, LCSW LLC Clinical CurrentSince Feb 1, 2015 Accepting new patients

Locations

10 N 2nd Ave
Highland Park, NJ 08904
Phone (201) 252-7069

3570 State Route 27
Ste 121
Kendall Park, NJ 08824

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508082496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SAGE COURT",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "732-438-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NORTH SECOND AVENUE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "08904",
            "telephone_number": "732-565-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LAURIE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SW44SC00261300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2030811",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, NJ

Sources for this page

Verify at the official NPI Registry.