Daniel Martin, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149005797 Issued in IL

Practice address

3010 Grand Ave
Waukegan, IL 60085-2321

Phone

(847) 377-8077

Fax

(847) 984-5682

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1598789885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8077",
            "fax_number": "847-984-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8077",
            "fax_number": "847-984-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DANIEL",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149005797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150004223",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyson Genell Marsalis, LCPC
• Britney Marsh
• Annette Kathleen Marshall, SLP
• Laura Marsolais
• Martha E. Diaz D.D.S., P.C.
• Kaitlynn Elizabeth Martin
• Timothy Collier Martin
• Maria Martinez Munoz
• Adela S Martinez, RN
• Agustin Rico Martinez

• Clinical Social Worker in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.