Individual provider Active NPI

Martha N Ricaldi, LCSW

  • Clinical Social Worker
  • Fort Hood, TX
National Provider Identifier
1962403246
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5040 Issued in FL
Practice address
Crdamc Department of Social Work
BLDG. 2255 52ND & 761St Tank Batallion Road
Fort Hood, TX 76544-4752
Phone
(254) 288-6474
Fax
(254) 288-3281
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 SW5040 FL Primary

Addresses

Primary practice location

Crdamc Department of Social Work
BLDG. 2255 52ND & 761St Tank Batallion Road
Fort Hood, TX 76544-4752

Mailing address

Carl R. Darnall Army Medical Center
36000 Darnall Loop
Fort Hood, TX 76544

Other identifiers 3

IdentifierTypeStateIssuer
7655525 00MedicaidFL
SW5040OtherFLQUALIFIED SUPERVISOR
SW5040OtherFLCLINICAL LICENSE

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
SW5040FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962403246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARL R. DARNALL ARMY MEDICAL CENTER",
            "address_2": "36000 DARNALL LOOP",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "76544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CRDAMC DEPARTMENT OF SOCIAL WORK",
            "address_2": "BLDG. 2255 52ND & 761ST TANK BATALLION ROAD",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765444752",
            "telephone_number": "254-288-6474",
            "fax_number": "254-288-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICALDI",
        "first_name": "MARTHA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7655525 00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALIFIED SUPERVISOR",
            "identifier": "SW5040",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL LICENSE",
            "identifier": "SW5040",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.