Individual
CARLA LYNN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
146 ELM ST STE A-12, CHESHIRE, CT 06410-2808
(203) 439-7545
Mailing address
141 FORGE DRIVE, AVON, CT 06001
(860) 404-8846
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005635
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004068284
—
CT
05
—
004215308
—
CT
05
—
008030935
—
CT
Enumeration date
05/08/2007
Last updated
11/26/2024
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