Provider Demographics
NPI:1841747557
Name:MARTIN, ANNE HAMILTON (PHD, LCSW-R)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:HAMILTON
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHD, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 58TH ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1477
Mailing Address - Country:US
Mailing Address - Phone:917-414-3820
Mailing Address - Fax:
Practice Address - Street 1:200 W 58TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1477
Practice Address - Country:US
Practice Address - Phone:917-414-3820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-10
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032054-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical