David Lance Martin, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Fairview, Utah. His current practice location is
125 N State St, Fairview, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 610-1810.
David Lance Martin is licensed to practice in Utah (license number 5001946-3501) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1861651325.
Healthcare Provider's Profile
| Full Name | David Lance Martin |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 125 N State St, Fairview, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1861651325
- Provider Enumeration Date: 06/09/2008
- Last Update Date: 06/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 6406042837
- Enrollment ID: I20101126000010
Medical Identifiers
Medical identifiers for David Lance Martin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1861651325 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 5001946-3501 (Utah) | Primary |
| 101YM0800X | Counselor - Mental Health | 5001946-3502 (Utah) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. David Lance Martin allows following entities to bill medicare on his behalf.
| Entity Name | Central Utah Counseling Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1639185424 PECOS PAC ID: 6305743618 Enrollment ID: O20031215000998 |
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| Entity Name | Rural Counseling Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518685411 PECOS PAC ID: 0446612410 Enrollment ID: O20230809000249 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. David Lance Martin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
David Lance Martin, LCSW 152 North 400 West, Ephraim, UT 84627-2131 Ph: (435) 283-8400 | David Lance Martin, LCSW 125 N State St, Fairview, UT 84629-5554 Ph: (435) 610-1810 |
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