Kristie Martin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6182 Issued in OK

Practice address

4175 S. Alamo Ave
Tucson, AZ 85707-4405

Phone

(520) 228-2615

NPI assigned

Aug 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kristie Midence Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1841699196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S. ALAMO AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857074405",
            "telephone_number": "520-228-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S. ALAMO AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857074405",
            "telephone_number": "520-228-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRISTIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "18711",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "6182",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIE",
            "last_name": "MIDENCE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Martin, PHARM D
• Jeffrey Fred Martin, O.D.
• Jennifer Joan Martin, M.D.
• Karreen Martin
• Krista H Martin, W.H.N.P.
• Laura Ann Martin
• Melanie Martin, DNP
• Patricia Diane Martin
• Pierre Martin, DDS
• Rachel Martin, LCSW

• Clinical Social Worker in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.