Angela Martin Psychotherapy, Llc in Racine - Clinical
Angela Martin Psychotherapy, Llc - NPI 1578688057
Angela Martin Psychotherapy, Llc is a Clinical in Racine, Wisconsin. Angela Martin Psychotherapy, Llc practices all healthcare services and medical treatments related to Clinical. The NPI Number for Angela Martin Psychotherapy, Llc is 1578688057. The last update date is 2020-08-22.
Angela Martin Psychotherapy, Llc's current location address is 6021 Durand Ave, Racine, Wisconsin. You can contact this provider via phone number 2625540126. The mailing address for Angela Martin Psychotherapy, Llc is 6021 Durand Ave, Racine, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Angela Martin Psychotherapy, Llc |
|---|---|
| Address | 6021 Durand Ave, Racine, Wisconsin |
| Phone Number | 2625540126 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Martin Angela |
| Credentials | LCSW |
| Telephone Number | 2625153220 |
NPI Number Detail
| NPI Number | 1578688057 |
|---|---|
| Provider Enumeration Date | 2007-03-21 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 6021 Durand Ave |
|---|---|
| City | Racine |
| State | Wisconsin (WI) |
| Post Code | 534065096 |
| Phone Number | 2625540126 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 6568-123 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39746200 | WI | -- |
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What is the Angela Martin Psychotherapy, Llc's 1578688057?
The Angela Martin Psychotherapy, Llc's NPI (National Provider Identifier) Number is 1578688057. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Angela Martin Psychotherapy, Llc?
The Angela Martin Psychotherapy, Llc is situated at 6021 Durand Ave, in the city of Racine, state of WI, with the zip code 534065096.
What is Angela Martin Psychotherapy, Llc's area of expertise and its corresponding taxonomy classification?
The Angela Martin Psychotherapy, Llc's field of specialization is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1578688057 assigned to Angela Martin Psychotherapy, Llc?
The Angela Martin Psychotherapy, Llc was issued its 1578688057 on 2007-03-21, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the Angela Martin Psychotherapy, Llc's information last updated?
The Angela Martin Psychotherapy, Llc's information was last updated on 2020-08-22.