Individual
MS. JENNIFER DAWN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
3040 RIVERSIDE DR STE 218, COLUMBUS, OH 43221-2579
(614) 636-0334
(614) 548-8663
Mailing address
3040 RIVERSIDE DR STE 218, COLUMBUS, OH 43221-2551
(614) 636-0334
(614) 548-8663
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E. 1200549
OH
101YP2500X
Professional Counselor
E. 1200549
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104214824
—
OH
Enumeration date
01/05/2015
Last updated
03/13/2024
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