Healthcare Provider Details

I. General information

NPI: 1518215763
Provider Name (Legal Business Name): FRANCES RAE MARTI LPCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2012
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 OGLETOWN-STANTON ROAD SUITE 124 MEDICAL ARTS PAVILLION
NEWARK DE
19713
US

IV. Provider business mailing address

237 WICKERBERRY DR
MIDDLETOWN DE
19709-7810
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-9900
  • Fax:
Mailing address:
  • Phone: 302-463-5391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-0000601
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: