Active NPI
Kristina Martin, LCSW
- Clinical Social Worker
- Wesley Chapel, FL
National Provider Identifier
1871866194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW4920
- Practice address
- 2352 Bruce B Downs Blvd Ste 304
Wesley Chapel, FL 33544 - Phone
- (813) 973-1304
- Fax
- (813) 355-5024
- NPI assigned
- Feb 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW4920 | FL | Primary |
Addresses
Primary practice location
2352 Bruce B Downs Blvd Ste 304
Wesley Chapel, FL 33544
Mailing address
38135 Market SQ
Zephyrhills, FL 33542-7539
Phone (352) 567-0188
Other practice location 1
2352 Bruce B Downs Blvd Ste 304
Wesley Chapel, FL 33544
Phone (813) 973-1304
Other practice location 2
9407 Azalea Ridge Cir
Tampa, FL 33647-2558
Phone (813) 382-6130
Other practice location 3
36763 Eiland Blvd Ste 201
Zephyrhills, FL 33542
Phone (813) 973-1304
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW4920 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574553600000",
"number": "1871866194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38135 MARKET SQ",
"city": "ZEPHYRHILLS",
"state": "FL",
"postal_code": "335427539",
"telephone_number": "352-567-0188",
"fax_number": "813-355-5101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2352 BRUCE B DOWNS BLVD STE 304",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "33544",
"telephone_number": "813-973-1304",
"fax_number": "813-355-5024"
}
],
"practiceLocations": [
{
"address_1": "2352 Bruce B Downs Blvd Ste 304",
"address_purpose": "LOCATION",
"city": "Wesley Chapel",
"state": "FL",
"postal_code": "33544",
"country_code": "US",
"telephone_number": "813-973-1304",
"fax_number": "813-355-5024",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9407 Azalea Ridge Cir",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336472558",
"country_code": "US",
"telephone_number": "813-382-6130",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "36763 Eiland Blvd Ste 201",
"address_purpose": "LOCATION",
"city": "Zephyrhills",
"state": "FL",
"postal_code": "33542",
"country_code": "US",
"telephone_number": "813-973-1304",
"fax_number": "813-355-5024",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "KRISTINA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-16",
"last_updated": "2019-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW4920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.