Active NPI
Victoria Lyn Martin, MSW, LCSW
- Counselor
- Waltham, MA
National Provider Identifier
1801960604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 211492
- Practice address
- 118 Central St
Waltham, MA 02453-5465 - Phone
- (781) 891-0556
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 211492 | MA | Primary |
Addresses
Primary practice location
118 Central St
Waltham, MA 02453-5465
Mailing address
118 Central St
Waltham, MA 02453-5465
Phone (781) 891-0556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100524000085 | MA | Practitioner - Clinical Social Worker | 2466581848 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 211492 | MA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Community Care, Inc. | Current | Accepting new patients |
Locations
270 Bridge St
Ste 301
Dedham, MA 02026
Phone (617) 230-9905
190 Lenox St
Norwood, MA 02062
Phone (781) 769-8670
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801960604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 CENTRAL ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024535465",
"telephone_number": "781-891-0556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 CENTRAL ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024535465",
"telephone_number": "781-891-0556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "VICTORIA",
"middle_name": "LYN",
"name_prefix": "Mrs.",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "211492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.