Provider Demographics
NPI:1649598640
Name:MATHER, MARTHA STRICKLAND (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:STRICKLAND
Last Name:MATHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 GLEN IRIS DR NE
Mailing Address - Street 2:#2505
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2963
Mailing Address - Country:US
Mailing Address - Phone:706-836-8914
Mailing Address - Fax:
Practice Address - Street 1:525 GLEN IRIS DR NE
Practice Address - Street 2:#2505
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2963
Practice Address - Country:US
Practice Address - Phone:706-836-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4049101YM0800X
GA005964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health