Individual provider Active NPI

Meaghan Lindsay Martin

  • Clinical Social Worker
  • Apple Valley, CA
National Provider Identifier
1710256961
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
93822 Issued in CA
Practice address
17800 US Highway 18
Apple Valley, CA 92307-1221
Phone
(760) 946-8200
Fax
(760) 242-1425
NPI assigned
Dec 16, 2011
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 69332 CA
Clinical Social Worker 1041C0700X 93822 CA Primary

Addresses

Primary practice location

17800 US Highway 18
Apple Valley, CA 92307-1221

Mailing address

17800 US Highway 18
Apple Valley, CA 92307-1221
Phone (760) 946-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220610001782 CA Practitioner - Clinical Social Worker 4284012782 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
69332CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Health Ipa CurrentSince Mar 17, 2022 Accepting new patients
Meaghan Martin Licensed Clinicial Social Worker Corporation Current Accepting new patients
Serene Health Mental Health CurrentSince Mar 17, 2022 Accepting new patients

Locations

4849 Ronson Ct
Ste 206
San Diego, CA 92111
Phone (619) 602-4557

4849 Ronson Ct
Ste 207
San Diego, CA 92111
Phone (619) 329-4483

9265 Sky Park Ct
Ste 100
San Diego, CA 92123
Phone (619) 329-4483

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1710256961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071221",
            "telephone_number": "760-946-8200",
            "fax_number": "760-242-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071221",
            "telephone_number": "760-946-8200",
            "fax_number": "760-242-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MEAGHAN",
        "middle_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-16",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "69332",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.