Provider Demographics
NPI:1659155018
Name:MARTIN, ISABELLE MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 ALCOTT RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4423
Mailing Address - Country:US
Mailing Address - Phone:757-333-1039
Mailing Address - Fax:
Practice Address - Street 1:327 W 21ST ST STE 205
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-2130
Practice Address - Country:US
Practice Address - Phone:757-656-6461
Practice Address - Fax:757-276-6741
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040157211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical