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General NPI Number Information
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NPI Number | 1093014292
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Entity Type | Individual
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Provider Name | EDWARD T MARTIN LPC
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Gender | Male
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 563 N MAIN ST
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City | WAYNESVILLE
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State | NC
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Zip | 28786-3817
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Country | US
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Telephone | 828-564-1282
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Fax | 828-564-1282
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Provider Business Mailing Address
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Address Line | 205 CALICO LN
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City | CLYDE
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State | NC
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Zip | 28721-8705
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Country | US
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Telephone | 828-564-1282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8147
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License Number State | NC
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