Active NPI
Lisan Martin
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1679781348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 00302518
- Practice address
- 2607 Connecticut Ave NW
Washington, DC 20008-1522 - Phone
- (202) 537-6614
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00302518 | DC | Primary |
Addresses
Primary practice location
2607 Connecticut Ave NW
Washington, DC 20008-1522
Mailing address
7707 Macarthur Blvd
Cabin John, MD 20818-1702
Phone (301) 229-7839
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2016 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00302518 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679781348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7707 MACARTHUR BLVD",
"city": "CABIN JOHN",
"state": "MD",
"postal_code": "208181702",
"telephone_number": "301-229-7839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2607 CONNECTICUT AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200081522",
"telephone_number": "202-537-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "LISAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "00302518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.