Individual
KATIE L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
60 S STOCKWELL RD, EVANSVILLE, IN 47714-0247
(812) 476-5437
(812) 422-7558
Mailing address
415 MULBERRY ST, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006728
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000847425
ANTHEM
IN
01
—
12627023
CAQH
—
01
—
153386
SIHO
IN
01
—
839090003
MEDICARE
IN
Enumeration date
11/18/2013
Last updated
10/23/2015
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