Jeremy Martin, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15493 Issued in SC

Practice address

2712 Middleburg Dr Ste 207B
Columbia, SC 29204-2445

Phone

(803) 274-3669

NPI assigned

May 18, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1841864485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 MIDDLEBURG DR STE 207B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042445",
            "telephone_number": "803-274-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 MIDDLEBURG DR STE 207B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042445",
            "telephone_number": "803-274-3669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2711 Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036818",
            "country_code": "US",
            "telephone_number": "803-587-9009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JEREMY",
        "credential": "LISW-CP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "11213",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel John Martin, M.D.
• Gina Abbruzzi Martin, MD
• Janet M. Martin, LMT
• Jeffery Scott Martin, MD
• Jemillia Nevaeh Martin
• John Bruce Martin, C.R.N.A.
• Justin Louis Martin, PT
• Karly Martin
• Katie Martin
• Kaylee Martin, MD

• Clinical Social Worker in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.