MEDICARE: MRS. MARTHA STRICKLAND MATHER LPC

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	4049	NC
2	101YM0800X	Mental Health Counselor	005964	GA

General Provider Information

NPI Number	:	1649598640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA STRICKLAND MATHER LPC

Provider Business Mailing Address
First Line	:	525 GLEN IRIS DR NE
Second Line	:	#2505
City	:	ATLANTA
State	:	GA
Zip	:	30308-2963
Country	:	US
Telephone Number	:	706-836-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 GLEN IRIS DR NE
Second Line	:	#2505
City	:	ATLANTA
State	:	GA
Zip	:	30308-2963
Country	:	US
Telephone Number	:	706-836-8914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2010
Last Update Date	:	05/14/2010

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