Carolyn C Martin, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P1184 Issued in TN

Practice address

8142 Country Village Dr # 102
Cordova, TN 38016-2029

Phone

(901) 388-1893

Fax

(901) 388-1995

NPI assigned

Jul 19, 2006

Last updated

Jul 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

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  • NPI 1932334828
  NPD (past)
• Wyatt L. Nichols, PH.D., PC

  • Clinical Psychologist
  • Cordova, TN
  • NPI 1356715445
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1710906466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8142 COUNTRY VILLAGE DR # 102",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162029",
            "telephone_number": "901-388-1893",
            "fax_number": "901-388-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8142 COUNTRY VILLAGE DR # 102",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162029",
            "telephone_number": "901-388-1893",
            "fax_number": "901-388-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CAROLYN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P1184",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TN",
            "license": "P1184",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3683378",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Marion
• Larissa S Marquez
• Raven Marshall
• Martha a Gordon, MD, PC
• Ashley Martin, PHARMD
• Cornelius Martin
• Durand Dale Martin Jr.
• Elizabeth Martin
• Laura Simmons Martin, M.A., CCC-SLP
• Paula M Martin, FNP-C

• Psychologist in Cordova, TN
• Providers in Cordova, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.