Provider Demographics
NPI:1952601213
Name:MARTIN, ALESHA NICOLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALESHA
Middle Name:NICOLE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10543 CEDAR GROVE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6525
Mailing Address - Country:US
Mailing Address - Phone:615-768-9295
Mailing Address - Fax:
Practice Address - Street 1:10543 CEDAR GROVE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6525
Practice Address - Country:US
Practice Address - Phone:615-768-9295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical