Organization
ENGEDI THERAPY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWANDA MARTIN LPC (OWNER)
(757) 867-5811
Entity
Organization
Contact information
Practice address
401 E SONTERRA BLVD STE 375, SAN ANTONIO, TX 78258-4321
(757) 867-5811
(757) 384-1581
Mailing address
401 E SONTERRA BLVD STE 375, SAN ANTONIO, TX 78258-4321
(757) 867-5811
(757) 384-1581
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006966
VA
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
—
1336489012
—
FL
Enumeration date
11/13/2017
Last updated
03/14/2023
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