Individual provider Active NPI

Christianna R Martin, LCSW

  • Clinical Social Worker
  • Bridgeton, NJ
National Provider Identifier
1598831109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00010700 Issued in NJ
Practice address
7 Bridgeton Ave
Bridgeton, NJ 08302
Phone
(856) 453-0888
Fax
(856) 453-0736
NPI assigned
Nov 27, 2006
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 44SC00010700 NJ Primary

Addresses

Primary practice location

7 Bridgeton Ave
Bridgeton, NJ 08302

Mailing address

7 Bridgeton Avenue
Bridgeton, NJ 08302
Phone (856) 453-0888

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
I20050406000306 NJ Practitioner - Clinical Social Worker 0446207054 Practice locations: Bridgeton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 Bridgeton Ave
Bridgeton, NJ 08302-1218
Phone (856) 453-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00010700NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598831109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BRIDGETON AVENUE",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "08302",
            "telephone_number": "856-453-0888",
            "fax_number": "856-453-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BRIDGETON AVE",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "08302",
            "telephone_number": "856-453-0888",
            "fax_number": "856-453-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHRISTIANNA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00010700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

Verify at the official NPI Registry.