Individual
JASON TIMOTHY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
351 WAGONER DR STE 418, FAYETTEVILLE, NC 28303-4608
(910) 580-4973
(855) 940-0214
Mailing address
351 WAGONER DR STE 418, FAYETTEVILLE, NC 28303-4608
(910) 580-4973
(855) 940-0214
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14728
NC
Other
Enumeration date
04/11/2019
Last updated
11/28/2023
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