Provider Demographics
NPI:1245939511
Name:MARTIN, STEVEN KENNETH (BA)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:KENNETH
Last Name:MARTIN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:208 STARFLOWER VW
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7715
Mailing Address - Country:US
Mailing Address - Phone:717-286-5362
Mailing Address - Fax:
Practice Address - Street 1:1148 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4359
Practice Address - Country:US
Practice Address - Phone:717-390-9086
Practice Address - Fax:717-390-9066
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health