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General NPI Number Information
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NPI Number | 1386288256
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Entity Type | Individual
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Provider Name | RIKKI JEANNE MARTIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 9805 STATESVILLE RD STE 6095
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City | CHARLOTTE
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State | NC
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Zip | 28269-7647
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Country | US
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Telephone | 704-360-5747
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 BATTLEGROUND AVE STE 220
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City | GREENSBORO
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State | NC
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Zip | 27410-2490
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Country | US
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Telephone |
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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 | C012549
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License Number State | NC
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