Provider Demographics
NPI:1841415940
Name:MARTIN, JANICE E (EDD, LPC)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59243
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35259-9243
Mailing Address - Country:US
Mailing Address - Phone:205-988-0805
Mailing Address - Fax:205-978-8099
Practice Address - Street 1:1957 HOOVER CT
Practice Address - Street 2:SUITE 218
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3622
Practice Address - Country:US
Practice Address - Phone:205-988-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL650101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional