Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kellie Martin, LCSW

Individual provider Clinical Social Worker · NPI 1770935116

MS. Kellie Martin, LCSW is a Clinical Social Worker in Central Islip, New York. Qualified in 2004, 22 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in New York and Washington.

Years since qualifying
22
Licensed in
NY, WA
In the registry since
2016
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

10 Hickory St
Central Islip, NY 11722-4704
Phone: (631) 335-9573
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6505 216th St Sw Ste 100, Mountlake Terrace, WA 98043-2089 — (425) 640-7009

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 084444-1 (NY)
Clinical Social Worker Taxonomy 1041C0700X · Licence LW61407523 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 08-4444 (NY)

Record details

NPI number1770935116
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJuly 11, 2016
Last updated in NPPESMay 15, 2024
Certification dateMarch 1, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Not indicated

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