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Individual

MR. MARTIN JOSEPH GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ACSW, LCSW

Contact information

Practice address
906 E MOUNTAIN PKWY, SALYERSVILLE, KY 41465-8379
(606) 349-8100
(606) 349-8150
Mailing address
PO BOX 280, PRESTONSBURG, KY 41653-0280
(606) 349-8100
(606) 349-8150

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005091A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100478310
KY
Enumeration date
03/12/2007
Last updated
07/21/2022
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