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NPI Code Detail

MEDICARE: MS. JENNIFER MARTIN LCPC

MEDICARE: MS. JENNIFER MARTIN LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1013146349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER MARTIN LCPC
Provider Business Mailing Address
First Line : 205 N FOZZARD ST
Second Line :
City : MARION
State : IL
Zip : 62959-1131
Country : US
Telephone Number : 618-542-5779
Fax Number :
Provider Business Practice Location Address
First Line : 812 SKYLINE DR STE 200
Second Line :
City : MARION
State : IL
Zip : 62959-4874
Country : US
Telephone Number : 618-440-1534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2009
Last Update Date : 06/17/2025

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Directions to “ MS. JENNIFER MARTIN LCPC” Practice Location

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