Provider Demographics
NPI:1982971453
Name:MARTON, PHYLLIS A (MA, LMHC, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:A
Last Name:MARTON
Suffix:
Gender:F
Credentials:MA, LMHC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-1521
Mailing Address - Country:US
Mailing Address - Phone:914-232-7217
Mailing Address - Fax:
Practice Address - Street 1:24 NORTH ST
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-1521
Practice Address - Country:US
Practice Address - Phone:914-232-7217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP79744101Y00000X
NY005351-1101YM0800X
CT002232101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional