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Individual
MICHAEL JACK MARTIN
Active
Individual
MICHAEL JACK MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA MFTI
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T2450
OR
106H00000X
Marriage & Family Therapist
70797
CA
106H00000X
Marriage & Family Therapist
97189
CA
106H00000X
Marriage & Family Therapist
Primary
T2450
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70797
BBS
CA
Enumeration date
06/01/2012
Last updated
07/24/2026
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