Provider Demographics
NPI:1356575732
Name:MARTIN, JAMES DOYLE (LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DOYLE
Last Name:MARTIN
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 VISOR DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3325
Mailing Address - Country:US
Mailing Address - Phone:210-268-4993
Mailing Address - Fax:210-481-9802
Practice Address - Street 1:1011 VISOR DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3325
Practice Address - Country:US
Practice Address - Phone:210-268-4993
Practice Address - Fax:210-481-9802
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13225101YP2500X
NM0071841101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional