Kellie Martin, LCSW
NPI 1770935116ActiveIndividual· Social Worker, Clinical· Central Islip, NY
Social Worker, Clinical (LCSW) in Central Islip, New York, licensed in NY and WA, with an NPI issued in July 2016. Enrolled in Medicare as practitioner - clinical social worker and practitioner - clinical social worker.
Overview
| NPI | 1770935116 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | Yes |
| NPI issued | Jul 11, 2016 |
| Last updated in NPPES | May 15, 2024 |
| Certified by provider | Mar 1, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 084444-1 | NY |
| Social Worker, Clinical | 1041C0700X | LW61407523 | WA |
| Social Worker, Clinical | 1041C0700X | 08-4444 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MA); Practitioner - Clinical Social Worker (NY); Practitioner - Clinical Social Worker (WA) |
|---|
Education and affiliations
| Graduation year | 2004 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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All 26 clinical social workers in Central Islip · All clinical social workers in New York