Provider Demographics
NPI:1467481895
Name:MARTIN, KATHERINE A (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:A
Other - Last Name:YUILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:540 W PLUMB LN
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3467
Mailing Address - Country:US
Mailing Address - Phone:775-240-0390
Mailing Address - Fax:
Practice Address - Street 1:540 W PLUMB LN
Practice Address - Street 2:SUITE 1B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3467
Practice Address - Country:US
Practice Address - Phone:775-240-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01976-C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health