MEDICARE: MARTIN'S CONSULTING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4250	LA

General Provider Information

NPI Number	:	1376978114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN'S CONSULTING SERVICES, LLC

Provider Business Mailing Address
First Line	:	717 S FOSTER DR
Second Line	:	SUITE 140
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-5943
Country	:	US
Telephone Number	:	225-207-5139
Fax Number	:	126-793-5784

Provider Business Practice Location Address
First Line	:	717 S FOSTER DR
Second Line	:	SUITE 140
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-5943
Country	:	US
Telephone Number	:	225-207-5139
Fax Number	:	126-793-5784

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CHARLES HAROLD MARTIN
Credential	:	LCSW-BACS
Telephone Number	:	225-207-5139

Provider Enumeration Date	:	09/11/2013
Last Update Date	:	09/11/2013

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