Wayne a Martin LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904000158 Issued in VA

Legal business name

WAYNE A MARTIN LCSW LLC

Practice address

708 Mobjack PL
Newport News, VA 23606-1957

Phone

(757) 873-1958

Fax

(757) 873-2143

NPI assigned

Feb 19, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Wayne A Martin, LCSW

Title

Licensed Clinical Social Worker

Phone

(757) 873-1958

Specialties & licenses 1

Addresses

Other names 1

• Wayne A Martin, LCSW, PC Former legal business name

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1649419342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 MOBJACK PL",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061957",
            "telephone_number": "757-873-1958",
            "fax_number": "757-873-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 MOBJACK PL",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061957",
            "telephone_number": "757-873-1958",
            "fax_number": "757-873-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE A MARTIN LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-19",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "757-873-1958",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne A Martin, LCSW, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Newport News, VA
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• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.