Individual provider Active NPI

Cynthia Martin, LICSW, CMHS

  • Clinical Social Worker
  • Kent, WA
National Provider Identifier
1942448741
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60713345 Issued in WA
Practice address
13036 SE Kent Kangley Rd Ste 378
Kent, WA 98030-7965
Phone
(253) 253-1595
NPI assigned
Feb 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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 LW60713345 WA Primary

Addresses

Primary practice location

13036 SE Kent Kangley Rd Ste 378
Kent, WA 98030-7965

Mailing address

13036 SE Kent Kangley Rd Ste 294
Kent, WA 98030-7965

Other identifiers 1

IdentifierTypeStateIssuer
1942448741MedicaidWA

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

LicenseStateTypeSpecialty
LW60713345WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eclipsea Mental Health Counseling, LLC Current Accepting new patients

Locations

13036 SE Kent Kangley Rd
Kent, WA 98030
Phone (253) 253-1595

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1942448741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13036 SE KENT KANGLEY RD STE 294",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13036 SE KENT KANGLEY RD STE 378",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307965",
            "telephone_number": "253-253-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CYNTHIA",
        "credential": "LICSW, CMHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60713345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942448741",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.