Doctor Name: | MRS. BRENDA K MARTIN |
NPI Number: | 1053496406 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW MSW |
License Number: | C000613 |
Business Practice Address: | 114 Court St Statesville, NC - 286775803 |
Business Phone Number: | 7048737816 |
Business Fax Number: | 7048737817 |
Mailing Address: | 114 Court St, STATESVILLE |
State: | NC |
Postal Code: | 286775803 |
Phone Number: | 7048737816 |
Fax Number: | 7048737817 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 08/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | C000613 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |