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Individual

MRS. BRENDA K MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW MSW

Contact information

Practice address
127 N GREEN ST, STATESVILLE, NC 28677-5375
(704) 873-7816
(704) 873-7817
Mailing address
127 N GREEN ST, STATESVILLE, NC 28677-5375
(704) 873-7816
(704) 873-7817

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C000613
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1010X
BCBS
NC
01
1010X
BCBS
05
6002130
NC
01
P00426430
RAILROAD MEDICARE
Enumeration date
10/26/2006
Last updated
11/17/2017
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