Kelli Michelle Martin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

255153 Issued in KY

Practice address

245 Fountain CT
Lexington, KY 40509-2792

Phone

(859) 323-6021

Fax

(859) 323-1670

NPI assigned

Dec 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelli Travillian Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• New Vista of the Bluegrass Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frankfort, KY
  • NPI 1790731081
  Medicare reassignment NPD
• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD
• Bluegrass Behavioral School for Children

  • Community/Behavioral Health Agency
  • Georgetown, KY
  • NPI 1922632249
  NPD
• New Vista of the Bluegrass Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, KY
  • NPI 1023359783
  NPD

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1699280206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 CHAMPION WAY STE 11",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FOUNTAIN CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092792",
            "telephone_number": "859-323-6021",
            "fax_number": "859-323-1670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Champion Way Ste 11",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403248862",
            "country_code": "US",
            "telephone_number": "502-603-0020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KELLI",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "TRAVILLIAN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jania Martin
• Julia E Martin, MD
• Julie Ann Martin, D.C.
• Julie Elizabeth Martin, MD
• Kathleen Martin, MD
• Kimberly Elaine Martin, BSN-RN
• Kristen Auberry Martin, MA/MS
• Laura Martin, RBT
• Laura Gail Martin, M.A. CCC-SLP
• Lindsey Jeanette Martin

• Clinical Social Worker in Lexington, KY
• Providers in Lexington, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.