=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700765047
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINSEY ANN MARTIN LPC ASSOCIATE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2025
-----------------------------------------------------
Last Update Date | 08/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 N LOOP 1604 E STE 2207
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78232-1399
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 726-268-0395
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5432 BLUEBELL MDW
-----------------------------------------------------
City | CONVERSE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78109-3309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-848-2874
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 97632
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------