Provider Demographics
NPI:1538829197
Name:MARTIN, FAITH
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HALL ST
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-1331
Mailing Address - Country:US
Mailing Address - Phone:606-276-1333
Mailing Address - Fax:
Practice Address - Street 1:118 GRAND VUE PLZ
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-6842
Practice Address - Country:US
Practice Address - Phone:606-487-1646
Practice Address - Fax:606-467-2088
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)