Provider Demographics
NPI:1508855768
Name:MARTIN, CATHERINE MARY (LCPC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARY
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:MARTIN-DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4226 BAR HARBOR PLACE
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2966
Mailing Address - Country:US
Mailing Address - Phone:301-580-1563
Mailing Address - Fax:301-929-9652
Practice Address - Street 1:1680 EAST GUDE DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-580-1563
Practice Address - Fax:301-929-9652
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCO491101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional