Individual provider Active NPI

Linda Jo Martin, LCSW

  • Clinical Social Worker
  • New Lenox, IL
National Provider Identifier
1962629535
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-003296 Issued in IL
Practice address
1938 E Lincoln Hwy Ste 203
New Lenox, IL 60451-3860
Phone
(773) 969-1885
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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 149-003296 IL Primary

Addresses

Primary practice location

1938 E Lincoln Hwy Ste 203
New Lenox, IL 60451-3860

Mailing address

1938 E Lincoln Hwy Ste 203
New Lenox, IL 60451-3860
Phone (773) 969-1885

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL mslindajomartin@gmail.com
Other URL 773-969-1885 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150924000291 IL Practitioner - Clinical Social Worker 1850608845 Practice locations: New Lenox, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1938 E Lincoln Hwy
Suite 203
New Lenox, IL 60451-3860
Phone (773) 404-0168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-003296ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert E. Puls, P.C. Past Accepting new patients

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1962629535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 E LINCOLN HWY STE 203",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513860",
            "telephone_number": "773-969-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 E LINCOLN HWY STE 203",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513860",
            "telephone_number": "773-969-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LINDA",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-003296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mslindajomartin@gmail.com",
            "affiliation": "N",
            "address_1": "1938 E Lincoln Hwy Ste 203",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604513860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "773-969-1885",
            "affiliation": "N",
            "endpointDescription": "mobile phone",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1938 E Lincoln Hwy",
            "address_2": "Ste 203",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.