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NPI Code Detail

MEDICARE: LAWANDA MARTIN LPC

MEDICARE: LAWANDA MARTIN LPC
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
1101YM0800XMental Health Counselor0701006966VA
2101YP2500XProfessional Counselor
3101YP2500XProfessional CounselorMH13508FL
4101YP2500XProfessional Counselor85425TX
5101YS0200XSchool CounselorVA
6101Y00000XCounselor
7101YA0400XAddiction (Substance Use Disorder) Counselor
8101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1823587210OTHERVAENGEDI THERAPY SERVICES, PLLC

General Provider Information

NPI Number : 1336489012
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWANDA MARTIN LPC
Provider Business Mailing Address
First Line : 401 E SONTERRA BLVD STE 375
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-4321
Country : US
Telephone Number : 757-867-5811
Fax Number : 757-384-1581
Provider Business Practice Location Address
First Line : 401 E SONTERRA BLVD STE 375
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-4321
Country : US
Telephone Number : 757-867-5811
Fax Number : 757-384-1581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2013
Last Update Date : 10/09/2022

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Directions to “ LAWANDA MARTIN LPC” Practice Location

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