Provider Demographics
NPI:1093844029
Name:MARTIN, MARGARET A (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W WILLIAM CANNON DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5253
Mailing Address - Country:US
Mailing Address - Phone:512-416-7246
Mailing Address - Fax:512-416-6791
Practice Address - Street 1:2501 W WILLIAM CANNON DR
Practice Address - Street 2:SUITE 401
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5253
Practice Address - Country:US
Practice Address - Phone:512-416-7246
Practice Address - Fax:512-416-6791
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192378101Medicaid
8J5932Medicare PIN