Healthcare Provider Details

I. General information

NPI: 1275182438
Provider Name (Legal Business Name): MARTHA LAW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2433 BROAD ST
CHATTANOOGA TN
37408-2910
US

IV. Provider business mailing address

807 FOX CHASE LN
HIXSON TN
37343-3211
US

V. Phone/Fax

Practice location:
  • Phone: 865-356-3076
  • Fax:
Mailing address:
  • Phone: 865-637-9711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: