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General NPI Number Information
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NPI Number | 1144552761
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Entity Type | Individual
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Provider Name | LISA ANN MARTIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/06/2010
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 4075 LINGLESTOWN RD # 390
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City | HARRISBURG
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State | PA
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Zip | 17112-1020
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Country | US
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Telephone | 940-784-3357
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Fax |
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Provider Business Mailing Address
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Address Line | 4075 LINGLESTOWN RD # 390
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City | HARRISBURG
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State | PA
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Zip | 17112-1020
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Country | US
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Telephone | 940-784-3357
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5895
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW023336
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C10643
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 41914
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License Number State | TX
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