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General NPI Number Information
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NPI Number | 1831668110
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Entity Type | Individual
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Provider Name | MARTHA MCCOOL
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Gender | Female
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Dates
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Enumeration Date | 11/16/2018
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 2578 BROADWAY # 607
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City | NEW YORK
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State | NY
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Zip | 10025-5642
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Country | US
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Telephone | 646-979-8031
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Fax |
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Provider Business Mailing Address
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Address Line | 1910 MADISON AVE PMB #87
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City | MEMPHIS
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State | TN
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Zip | 38104
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Country | US
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Telephone | 646-979-8031
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61445607
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC004144
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN0000024885
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 405009
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License Number State | NY
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