Provider Demographics
NPI:1578059796
Name:HOWARD, MARTHA ANN (CSW)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ANN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 MCBRAYER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40313-9600
Mailing Address - Country:US
Mailing Address - Phone:606-356-0617
Mailing Address - Fax:
Practice Address - Street 1:125 S MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-1065
Practice Address - Country:US
Practice Address - Phone:606-638-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2534231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical