Organization
CARROLL MARTIN LCSW - LLC
Active
Parent organization
CARROLL MARTIN LCSW - LLC
Other names
Blue Ridge Therapy Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARROLL MARTIN LCSW - LLC
Authorized official
CARROLL MARTIN LCSW (OWNER / CEO)
(540) 406-1717
Entity
Organization
Contact information
Practice address
41631 OLIVINE PL, ALDIE, VA 20105-5682
(703) 775-4102
Mailing address
41631 OLIVINE PL, ALDIE, VA 20105-5682
(703) 775-4102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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