Provider Demographics
NPI:1467988980
Name:MARTIN, ZACHARY PAUL (LCSW)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:PAUL
Last Name:MARTIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10025 INVESTMENT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2665
Mailing Address - Country:US
Mailing Address - Phone:865-606-6110
Mailing Address - Fax:865-312-6442
Practice Address - Street 1:10025 INVESTMENT DR STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-2665
Practice Address - Country:US
Practice Address - Phone:865-606-6110
Practice Address - Fax:865-312-6442
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW762291041C0700X
CALCSW1004931041C0700X
TNLSW00000077971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical