Individual
KATHLEEN NOLAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2305 N PARHAM RD STE 3, RICHMOND, VA 23229-3156
(804) 399-3515
(804) 270-2090
Mailing address
4310 METRO PKWY, STE 205, FORT MYERS, FL 33916-9416
(239) 236-8784
(239) 790-2624
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904006660
VA
1041C0700X
Clinical Social Worker
Primary
SW12038
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4945255
—
VA
Enumeration date
09/28/2007
Last updated
01/28/2022
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