Provider Demographics
NPI:1760841647
Name:MARTIN, MECCA MAJOR (PHD LMFT)
Entity Type:Individual
Prefix:
First Name:MECCA
Middle Name:MAJOR
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHD LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 CORINNE DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-5637
Mailing Address - Country:US
Mailing Address - Phone:504-377-3151
Mailing Address - Fax:
Practice Address - Street 1:1222 SAINT FERDINAND ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-7250
Practice Address - Country:US
Practice Address - Phone:504-947-1765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMFT1240106H00000X, 106H00000X
LA1290171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator