Provider Demographics
NPI:1598882672
Name:LITCHFIELD, MARTY (LMFT)
Entity Type:Individual
Prefix:
First Name:MARTY
Middle Name:
Last Name:LITCHFIELD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:LOCKHART
Mailing Address - State:TX
Mailing Address - Zip Code:78644-0577
Mailing Address - Country:US
Mailing Address - Phone:512-376-5042
Mailing Address - Fax:512-398-5696
Practice Address - Street 1:896 ROBIN RANCH RD
Practice Address - Street 2:
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644-4578
Practice Address - Country:US
Practice Address - Phone:512-376-2101
Practice Address - Fax:512-398-5696
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99023106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist