MEDICARE: CAROLYN MARTINWOOD

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	33010271A	IN

General Provider Information

NPI Number	:	1316625049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN MARTINWOOD

Provider Business Mailing Address
First Line	:	3502 GLEN HILLS DR
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-2541
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 FULTON ST E STE 222
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-3262
Country	:	US
Telephone Number	:	812-599-7204
Fax Number	:

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

Provider Enumeration Date	:	07/11/2023
Last Update Date	:	03/09/2026

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Directions to “ CAROLYN MARTINWOOD ” Practice Location

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