Elizabeth Brooke Martin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2020005419 Issued in MO

Practice address

2148 W Chesterfield Blvd Ste E205
Springfield, MO 65807-8650

Phone

(417) 812-6850

Fax

(417) 812-6858

NPI assigned

Jan 10, 2017

Sex

Female

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)

Enrolled

State licenses

Practice roles

Locations

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.

• The Mind and Body Clinic

  • Clinical Social Worker
  • Springfield, MO
  • NPI 1164187027
  NPD Authorized official
• Advocates for a Healthy Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Springfield, MO
  • NPI 1366575573
  NPD (past)

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1851837199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2148 W CHESTERFIELD BLVD STE E205",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658078650",
            "telephone_number": "417-655-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 W CHESTERFIELD BLVD STE E205",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658078650",
            "telephone_number": "417-812-6850",
            "fax_number": "417-812-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ELIZABETH",
        "middle_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2016035397",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020005419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Martin, FNP
• Alicia Leslie Martin, C-NPT, NNP-BC
• Barry Dean Martin
• Blake Andrew Martin, P.A.
• Chance Martin, DPT
• Hope Martin
• Joe Davis Martin, LPC
• Jordan Martin
• Kathleen Martin, CNP
• Kathleen Anne Martin, MACCCSLP

• Clinical Social Worker in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.