Provider Demographics
NPI:1619051463
Name:MARTEL, RAND G (LCPC, LMFT)
Entity Type:Individual
Prefix:MR
First Name:RAND
Middle Name:G
Last Name:MARTEL
Suffix:
Gender:M
Credentials:LCPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 LONG DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-4440
Mailing Address - Country:US
Mailing Address - Phone:208-327-3533
Mailing Address - Fax:208-898-8989
Practice Address - Street 1:2273 E GALA ST STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-7289
Practice Address - Country:US
Practice Address - Phone:208-898-8999
Practice Address - Fax:208-898-8989
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-2982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health