Provider Demographics
NPI:1497838122
Name:MARTIN, JOYCE ANN (LPC TX 14944)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:ANN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPC TX 14944
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 MANCHACA RD
Mailing Address - Street 2:STE 203
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745
Mailing Address - Country:US
Mailing Address - Phone:512-447-7044
Mailing Address - Fax:512-447-9013
Practice Address - Street 1:4515 MANCHACA RD
Practice Address - Street 2:STE 203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-447-7044
Practice Address - Fax:512-447-9013
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14944101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX027983801Medicaid