Provider Demographics
NPI:1003630849
Name:MARTIN, LUANNE EAST (LPC)
Entity type:Individual
Prefix:MRS
First Name:LUANNE
Middle Name:EAST
Last Name:MARTIN
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:PO BOX 659
Mailing Address - Street 2:
Mailing Address - City:HAMSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77622-0659
Mailing Address - Country:US
Mailing Address - Phone:281-917-5973
Mailing Address - Fax:
Practice Address - Street 1:17311 LEAGUE ROAD
Practice Address - Street 2:
Practice Address - City:HAMSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77622-0659
Practice Address - Country:US
Practice Address - Phone:281-917-5973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72114101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor