Provider Demographics
NPI:1902648074
Name:MARTIN, NATALIE MARLENE (LMFT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARLENE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 TOPANGA CANYON BLVD STE 222
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4688
Mailing Address - Country:US
Mailing Address - Phone:603-781-6486
Mailing Address - Fax:
Practice Address - Street 1:5855 TOPANGA CANYON BLVD STE 222
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-4688
Practice Address - Country:US
Practice Address - Phone:603-781-6486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132835106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist