Shannon R Martin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-13585 Issued in AZ

Practice address

17505 N 79TH Ave Ste 304a
Glendale, AZ 85308-8729

Phone

(623) 606-5522

Fax

(623) 878-5800

NPI assigned

Jan 27, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elevation Counseling and Consulting LLC

  • Clinical Social Worker
  • Glendale, AZ
  • NPI 1699435230
  Medicare reassignment NPD Authorized official
• Desert View Counseling and Consulting, Inc.

  • Community/Behavioral Health Agency
  • Peoria, AZ
  • NPI 1730553496
  NPD (past)

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1962708685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7558 W THUNDERBIRD RD STE 1-492",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853816080",
            "telephone_number": "623-606-5522",
            "fax_number": "623-878-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE STE 304A",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088729",
            "telephone_number": "623-606-5522",
            "fax_number": "623-878-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHANNON",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-13585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "709592",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Michelle Martin, D.O.
• Denise Martin
• Heidi Elizabeth Martin, MC, LPC
• Kelly Martin, COTA
• Richard Fleming Martin, DDS
• Will Martin
• Miguel Martinez Gonzalez
• Stephanie D Martinez Hawthorne, M.D.
• Yamileth Martinez-Lewis
• Julissa Martinez-Werth, B.A.

• Clinical Social Worker in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.