Provider Demographics
NPI:1225046600
Name:MARTIN, CATHY S (LPC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:S
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 POVERTY POINT CIR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-8427
Mailing Address - Country:US
Mailing Address - Phone:325-675-5605
Mailing Address - Fax:325-675-5605
Practice Address - Street 1:50 POVERTY POINT CIR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-8427
Practice Address - Country:US
Practice Address - Phone:325-675-5605
Practice Address - Fax:325-675-5605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11932101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11932OtherLPC PROVIDER NUMBER
TX1466807101Medicaid