Individual provider Active NPI

Melissa Lynn Martin

  • Clinical Social Worker
  • Clemmons, NC
National Provider Identifier
1942731666
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2554 Lewisville Clemmons Rd Ste 112
Clemmons, NC 27012-9927
Phone
(336) 283-2510
Fax
(336) 776-0091
NPI assigned
Mar 23, 2017
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 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 NU Primary

Addresses

Primary practice location

2554 Lewisville Clemmons Rd Ste 112
Clemmons, NC 27012-9927

Mailing address

2554 Lewisville Clemmons Rd Ste 112
Clemmons, NC 27012-9927
Phone (336) 283-2510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415000484 NC Practitioner - Clinical Social Worker 3577088384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Achieving Changes Counseling Services PLLCGroup PAC ID 6002161296, 3 clinicians

Practice addresses (Care Compare)

2554 Lewisville Clemmons Rd
Suite 112
Clemmons, NC 27012-9927
Phone (336) 283-2510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
West Forsyth Pain Management CurrentSince Oct 20, 2024 Accepting new patients
Achieving Changes Counseling Services, PLLC Mental Health CurrentSince Apr 1, 2025 Accepting new patients

Locations

2554 Lewisville Clemmons Rd
Ste 112
Clemmons, NC 27012
Phone (336) 283-2510

3540 Clemmons Rd
Ste 20
Clemmons, NC 27012
Phone (336) 283-2510

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1942731666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE CLEMMONS RD STE 112",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129927",
            "telephone_number": "336-283-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE CLEMMONS RD STE 112",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129927",
            "telephone_number": "336-283-2510",
            "fax_number": "336-776-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.