Kimber Joy Martinez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007727A Issued in IN

Practice address

1630 Klondike Rd
West Lafayette, IN 47906-4801

Phone

(765) 491-0566

NPI assigned

Jul 5, 2022

Last updated

Jul 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimber Joy Nicoletti-Martinez Professional name

Medicare fee-for-service enrollment

Enrolled in IN

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment
• Family Psychiatric Center LLC

  dba Donald Roegner MD

  • Psychiatry Physician
  • Kokomo, IN
  • NPI 1245302934

  Clinical

  NPD

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1972236289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 KLONDIKE RD",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479064801",
            "telephone_number": "765-491-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 KLONDIKE RD",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479064801",
            "telephone_number": "765-491-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KIMBER",
        "middle_name": "JOY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007727A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBER",
            "last_name": "NICOLETTI-MARTINEZ",
            "middle_name": "JOY",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sara Ann Marlow
• Kenneth E Marnocha, MD
• Phyllis Martin-Simmerman, MD
• Steven C Martin, MD
• Amanda Lee Martinez
• Brenda Masiga-Crowell
• Ellen Marie Mason, BCBA
• Mackenzie Massingill, BCBA
• Julie T Massoth, NP
• Gidget J Master, RBT

• Clinical Social Worker in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.