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

Stephanie Clark Martin, LICSW, LCSW

Individual provider Clinical Social Worker · NPI 1932798261

Stephanie Clark Martin, LICSW, LCSW is a Clinical Social Worker in Fairfax, Virginia. Qualified in 2010, 16 years ago. Practices with Northern Virginia Older Adult Counseling, a 20-clinician group, accepts Medicare assignment and offers telehealth. Licensed in District of Columbia and Virginia.

Years since qualifying
16
Licensed in
DC, VA
In the registry since
2021
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.
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

10615 Judicial Dr Ste 301
Fairfax, VA 22030-7501
Phone: (703) 402-2091
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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 0904012093 (VA)
Clinical Social Worker Taxonomy 1041C0700X · Licence LC50079674 (DC)

Record details

NPI number1932798261
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW , LCSW
Sole proprietorNo
NPI enumeratedJanuary 12, 2021
Last updated in NPPESJanuary 12, 2021
Certification dateJanuary 12, 2021

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Northern Virginia Older Adult Counseling — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Fairfax