Provider Demographics
NPI:1699924498
Name:MARTIN, FIANA L (LSCSW)
Entity type:Individual
Prefix:
First Name:FIANA
Middle Name:L
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 SW GAGE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1774
Mailing Address - Country:US
Mailing Address - Phone:785-845-0676
Mailing Address - Fax:785-408-5612
Practice Address - Street 1:1119 SW GAGE BLVD STE B
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1774
Practice Address - Country:US
Practice Address - Phone:785-845-0676
Practice Address - Fax:785-408-5612
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS59301041C0700X
KS42671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical