Provider Demographics
NPI:1033388756
Name:NOWAK, MARTIN R (LPCC-S)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:R
Last Name:NOWAK
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 S REYNOLDS RD STE B
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7411
Mailing Address - Country:US
Mailing Address - Phone:419-787-3780
Mailing Address - Fax:419-754-2510
Practice Address - Street 1:1351 S REYNOLDS RD STE B
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7411
Practice Address - Country:US
Practice Address - Phone:419-787-3780
Practice Address - Fax:419-754-2510
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0007057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional