Individual
STACY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LAC, CACI
Contact information
Practice address
301 HALTON RD STE F, GREENVILLE, SC 29607-3498
(864) 479-4226
Mailing address
301 HALTON RD STE F, GREENVILLE, SC 29607-3498
(864) 479-4226
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1802226
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
454
SC
101YP2500X
Professional Counselor
Primary
6779
SC
Other
Enumeration date
07/07/2015
Last updated
08/14/2023
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