Provider Demographics
NPI:1104680370
Name:MARTIN, RASHOD K (BSW CSW)
Entity type:Individual
Prefix:
First Name:RASHOD
Middle Name:K
Last Name:MARTIN
Suffix:
Gender:M
Credentials:BSW CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9752
Mailing Address - Country:US
Mailing Address - Phone:609-382-2714
Mailing Address - Fax:
Practice Address - Street 1:6010 BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9752
Practice Address - Country:US
Practice Address - Phone:609-382-2714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker