Provider Demographics
NPI:1205410677
Name:KRISTI MARTH MA LPC NCC PLLC
Entity Type:Organization
Organization Name:KRISTI MARTH MA LPC NCC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-872-3617
Mailing Address - Street 1:38723 MONTEREY DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1353
Mailing Address - Country:US
Mailing Address - Phone:586-872-3617
Mailing Address - Fax:
Practice Address - Street 1:38723 MONTEREY DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1353
Practice Address - Country:US
Practice Address - Phone:586-872-3617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1659783785OtherNPI 1
MI6401013748OtherSTATE LICENSURE