Provider Demographics
NPI:1033778105
Name:MARTEN, STEPHEN (LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:MARTEN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 866
Mailing Address - Street 2:
Mailing Address - City:SEELEY LAKE
Mailing Address - State:MT
Mailing Address - Zip Code:59868-0866
Mailing Address - Country:US
Mailing Address - Phone:509-699-8589
Mailing Address - Fax:
Practice Address - Street 1:151 BUSINESS CENTER LOOP
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-8559
Practice Address - Country:US
Practice Address - Phone:406-730-3454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LPCP-LIC-38064101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health