MEDICARE: KAITLIN MARTIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6851116519	MI

General Provider Information

NPI Number	:	1366209942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN MARTIN

Provider Business Mailing Address
First Line	:	26462 STOLLMAN DR
Second Line	:
City	:	INKSTER
State	:	MI
Zip	:	48141-1338
Country	:	US
Telephone Number	:	734-756-2497
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 S HURON PKWY
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-5133
Country	:	US
Telephone Number	:	800-693-1916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2024
Last Update Date	:	03/16/2026

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Directions to “ KAITLIN MARTIN ” Practice Location

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