Provider Demographics
NPI:1225278146
Name:MARTIN, APRIL (LCSW)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
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 1:104 REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-1177
Mailing Address - Country:US
Mailing Address - Phone:270-678-4801
Mailing Address - Fax:270-678-3866
Practice Address - Street 1:104 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1177
Practice Address - Country:US
Practice Address - Phone:270-678-4801
Practice Address - Fax:270-678-3866
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2522291041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30604011Medicaid