Individual
CONNIE ANN MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC LMFT
Contact information
Practice address
2466 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-2747
Mailing address
PO BOX 6430, SPRINGDALE, AR 72766-6430
(479) 450-2020
(479) 750-2747
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
P0501006
AR
106H00000X
Marriage & Family Therapist
Primary
M05001003
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y342
BLUE SHIELD PROVIDER#
AZ
Enumeration date
06/14/2006
Last updated
09/11/2025
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