Look up the most recent NPI and PECOS records

Wayne A Martin Lcsw Llc

(<Unavail>)

Social Worker

Behavioral Health & Social Service Providers

708 Mobjack Pl, Newport News, VA 23606-1957

(757) 873-1958

PECOS Enrollment

Based on the most recent information from CMS, provider Wayne A Martin Lcsw Llc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1649419342
Provider Type
Organization
Full Name
Wayne A Martin Lcsw Llc
Other Name
<Unavail>

Subpart
No
Enumeration Date
2/19/2009
Last Updated
4/24/2012

Contact Information

Practice Location

708 Mobjack Pl, Newport News, VA 23606-1957

(757) 873-1958

(757) 873-2143

Mailing Location

708 Mobjack Pl, Newport News, VA 23606-1957

(757) 873-1958

(757) 873-2143

Authorized Official

Martin, Wayne A (Licensed Clinical Social Worker)

(757) 873-1958

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0904000158 Virginia

Wayne A Martin Lcsw Llc

(<Unavail>)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

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