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

Shannon R Martin, LCSW

Individual provider Clinical Social Worker · NPI 1962708685

Shannon R Martin, LCSW is a Clinical Social Worker in Glendale, Arizona. Qualified in 1998, 28 years ago. Accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
28
Licensed in
AZ
In the registry since
2011
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

17505 N 79th Ave Ste 304A
Glendale, AZ 85308-8729
Phone: (623) 606-5522
Fax: (623) 878-5800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-13585 (AZ)

Record details

NPI number1962708685
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJanuary 27, 2011
Last updated in NPPESJuly 16, 2021
Certification dateJuly 16, 2021

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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