Provider Demographics
NPI:1356489587
Name:ACKERMAN-MARTIN, KAY (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:ACKERMAN-MARTIN
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W 3RD AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2843
Mailing Address - Country:US
Mailing Address - Phone:614-487-0785
Mailing Address - Fax:
Practice Address - Street 1:1500 W 3RD AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2843
Practice Address - Country:US
Practice Address - Phone:614-487-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1772101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor