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NPI Code Detail

MEDICARE: MADELYN ANTLE MARTIN LMSW

MEDICARE: MADELYN ANTLE MARTIN LMSW
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
1104100000XSocial Worker17705LA

General Provider Information

NPI Number : 1801509468
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELYN ANTLE MARTIN LMSW
Provider Business Mailing Address
First Line : 13582 BLACKWATER RD
Second Line :
City : BAKER
State : LA
Zip : 70714-6800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13582 BLACKWATER RD
Second Line :
City : BAKER
State : LA
Zip : 70714-6800
Country : US
Telephone Number : 225-930-8058
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2022
Last Update Date : 03/09/2026

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Directions to “ MADELYN ANTLE MARTIN LMSW” Practice Location

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