Provider Demographics
NPI:1639874837
Name:MARTIN, JAMES H (LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:MARTIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:314 MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:GALLITZIN
Mailing Address - State:PA
Mailing Address - Zip Code:16641-1414
Mailing Address - Country:US
Mailing Address - Phone:814-242-6823
Mailing Address - Fax:
Practice Address - Street 1:119 WALNUT ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1625
Practice Address - Country:US
Practice Address - Phone:814-534-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015478101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional