Individual provider Active NPI

Martha T Early, LCSW, LCAS, CCS

  • Clinical Social Worker
  • Norfolk, VA
National Provider Identifier
1972523561
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904003705 Issued in VA
Practice address
825 Fairfax Ave
Suite 118
Norfolk, VA 23507-1914
Phone
(757) 446-5955
Fax
(757) 446-5196
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 732 NC
Clinical Social Worker 1041C0700X C002940 NC
Clinical Social Worker 1041C0700X 0904003705 VA Primary

Addresses

Primary practice location

825 Fairfax Ave
Suite 118
Norfolk, VA 23507-1914

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5955

Other identifiers 14

IdentifierTypeStateIssuer
1972523561OtherVAVALUE OPTIONS
PAROtherVAMULTIPLAN
PAROtherVAVIRGINIA PREMIER HEALTH
PAROtherVAAETNA
PAROtherVAUSA MANAGED CARE
PAROtherVACORVEL/CORECARE
1972523561OtherVACOVENTRY HEALTH
2711554OtherVACIGNA BEHAVIORAL HEALTH
365405OtherVAANTHEM BEHAVIORAL HEALTH (PORTSMOUTH FAMILY MEDICINE)
600538-662OtherVAMAGELLAN HEALTH SERVICES
PAROtherVAVIRGINIA HEALTH NETWORK
PAROtherVASENTARA/OPTIMA BEHAVIORAL HEALTH
365403OtherVAANTHEM BEHAVIORAL HEALTH (GHENT FAMILY MEDICINE)
1972523561MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081222000615 VA Practitioner - Clinical Social Worker 9931261104 Reassigns benefits to 1 organization
I20190904000572 NC Practitioner - Clinical Social Worker 9931261104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pamlico River Behavioral Health, PLLCGroup PAC ID 6608105408, 3 clinicians

Practice addresses (Care Compare)

100 E Main St
Washington, NC 27889-4928
Phone (252) 940-1611

15221 Carrollton Blvd
Suite 207208
Carrollton, VA 23314-2325
Phone (252) 940-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904003705VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pamlico River Behavioral Health, PLLC Clinical CurrentSince Jun 26, 2019 Accepting new patients
Albemarle Behavioral Medicine, PC Past Accepting new patients
Coastal Podiatry, Inc PastSince Jan 1, 2009 Accepting new patients

Locations

100 E Main St
Washington, NC 27889
Phone (252) 940-1611

110 S Respess St
Washington, NC 27889

15221 Carrollton Blvd
Ste 207208
Carrollton, VA 23314
Phone (252) 623-2736

Organizations & group practices 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1972523561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-5955",
            "fax_number": "757-446-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "SUITE 118",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-5955",
            "fax_number": "757-446-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLY",
        "first_name": "MARTHA",
        "middle_name": "T",
        "credential": "LCSW, LCAS, CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "732",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002940",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "1972523561",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL/CORECARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH",
            "identifier": "1972523561",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2711554",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BEHAVIORAL HEALTH (PORTSMOUTH FAMILY MEDICINE)",
            "identifier": "365405",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "600538-662",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA BEHAVIORAL HEALTH",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BEHAVIORAL HEALTH (GHENT FAMILY MEDICINE)",
            "identifier": "365403",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972523561",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.