Provider Demographics
NPI:1477756682
Name:MARTIN, ELIZABETH ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:6771 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74129-6201
Mailing Address - Country:US
Mailing Address - Phone:918-361-6335
Mailing Address - Fax:
Practice Address - Street 1:7010 S YALE AVE STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5702
Practice Address - Country:US
Practice Address - Phone:918-948-4040
Practice Address - Fax:918-495-0779
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor