Individual provider Active NPI

Michael Martin, LICSW

  • Clinical Social Worker
  • White River Junction, VT
National Provider Identifier
1851155923
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0135719 Issued in VT
Practice address
US Dept of Veteran Affairs 215 North Main St
White River Junction, VT 05009-0001
Phone
(802) 295-9363
NPI assigned
Feb 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089.0135719 VT Primary

Addresses

Primary practice location

US Dept of Veteran Affairs 215 North Main St
White River Junction, VT 05009-0001

Mailing address

US Dept of Veteran Affairs 215 North Main St
White River Junction, VT 05009-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
089.0135719VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1851155923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "US DEPT OF VETERAN AFFAIRS 215 NORTH MAIN ST",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US DEPT OF VETERAN AFFAIRS 215 NORTH MAIN ST",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001",
            "telephone_number": "802-295-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHAEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0135719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White River Junction, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.