Individual
KATHRYN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006291
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000724799
ANTHEM
IN
05
—
100240880
—
IN
01
—
12271465
CAQH
IN
Enumeration date
08/08/2008
Last updated
08/23/2023
Update your record
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