Provider Demographics
NPI:1275879694
Name:HINSON, MARTHA T (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:T
Last Name:HINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 PREACHERS HOLLOW TRL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-2903
Mailing Address - Country:US
Mailing Address - Phone:719-352-2718
Mailing Address - Fax:
Practice Address - Street 1:4806 PREACHERS HOLLOW TRL
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-2903
Practice Address - Country:US
Practice Address - Phone:719-352-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6416101YM0800X
SC2007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health