Individual provider Active NPI

Shaune Christopher Martin, LCSW

  • Clinical Social Worker
  • Pawcatuck, CT
National Provider Identifier
1992281950
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
010899 Issued in CT
Practice address
43 W Broad St Unit 7
Pawcatuck, CT 06379-4309
Phone
(860) 245-8548
NPI assigned
Jul 12, 2018
Last updated
Sep 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2026

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 010899 CT Primary

Addresses

Primary practice location

43 W Broad St Unit 7
Pawcatuck, CT 06379-4309

Mailing address

43 W Broad St Unit 7
Pawcatuck, CT 06379-4309
Phone (860) 245-8548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20201218000762 CT Practitioner - Clinical Social Worker 5294147013 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

43 W Broad St
Unit 1
Pawcatuck, CT 06379-4307
Phone (860) 245-8548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010899CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Agency of Southeastern Connecticut, Inc. CurrentSince Nov 3, 2020 Accepting new patients
Child and Family Agency of Southeastern Connecticut, Inc. CurrentSince Nov 3, 2020 Accepting new patients
Shaune Martin Therapy CurrentSince Aug 1, 2022 Accepting new patients

Locations

591 Poquonnock Rd
Groton, CT 06340
Phone (860) 449-8217

255 Hempstead St
New London, CT 06320

43 W Broad St
Unit 1
Pawcatuck, CT 06379
Phone (401) 219-1133

43 W Broad St
Unit 4
Pawcatuck, CT 06379
Phone (860) 245-8548

43 W Broad St
Unit 7
Pawcatuck, CT 06379
Phone (860) 245-8548

4 Grove Beach Rd N
Ste 2D
Westbrook, CT 06498

Interoperability endpoints

  • Direct secure messaging: shaune.martin@xdr.hhchealthdirect.org

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788566400000",
    "number": "1992281950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 W BROAD ST UNIT 7",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063794309",
            "telephone_number": "860-245-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 W BROAD ST UNIT 7",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063794309",
            "telephone_number": "860-245-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHAUNE",
        "middle_name": "CHRISTOPHER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2026-09-05",
        "certification_date": "2026-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawcatuck, CT

Sources for this page

Verify at the official NPI Registry.