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

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1487430757

Stephanie Ailis Martin is a Clinical Social Worker in Bullock, North Carolina. Graduated from Boston University School of Medicine in 2022, 4 years ago. Practices with Southside Behavioral Health, a 16-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Trained at
Boston University School of Medicine
Licensed in
NC
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

9553 Whippoorwill Ridge Rd
Bullock, NC 27507-9362
Phone: (434) 774-5505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence P018296 (NC)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LCAS-29171 (NC)

Record details

NPI number1487430757
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 4, 2023
Last updated in NPPESSeptember 4, 2023
Certification dateSeptember 3, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolBOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice Southside Behavioral Health — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Colleagues at Southside Behavioral Health

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 16 clinicians in the practice; 12 are shown here.