Individual
DR. LELAND KARL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2434 COMMERCE BLVD STE A, MOUND, MN 55364-1480
(952) 595-0562
(952) 595-0564
Mailing address
2434 COMMERCE BLVD STE A, MOUND, MN 55364-1480
(952) 595-0562
(952) 595-0564
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3095
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109951
BEHAVIORAL HEALTH CARE PR
MN
01
—
169220
COMPSYCH
MN
01
—
5H813MA
BLUE CROSS BLUE SHIELD
MN
01
—
6129689
UNITED BEHAVIORAL HEALTH
MN
05
—
783725900
—
MN
01
—
HP27418
HEALTH PARTNERS
MN
Enumeration date
06/06/2006
Last updated
07/07/2022
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