Provider Demographics
NPI:1346856689
Name:SEEDS MARTIN, LORI JANEAN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JANEAN
Last Name:SEEDS MARTIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 STABLE OAKS
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-4006
Mailing Address - Country:US
Mailing Address - Phone:512-771-9766
Mailing Address - Fax:
Practice Address - Street 1:155 HILLCREST LANE
Practice Address - Street 2:COMMUNITY RESOURCE CENTER
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642
Practice Address - Country:US
Practice Address - Phone:512-771-9766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37495104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker