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General NPI Number Information
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NPI Number | 1477848752
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Entity Type | Individual
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Provider Name | CAROL K MARTELL LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 838 COLUMBIA ST
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City | SANTA FE
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State | NM
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Zip | 87505-3965
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Country | US
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Telephone | 505-227-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 PLACITA LOMA
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City | SANTA FE
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State | NM
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Zip | 87501-1613
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Country | US
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Telephone | 505-400-4936
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0129921
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License Number State | NM
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