Individual
LISA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 CONCORD PIKE, WILMINGTON, DE 19803-3612
(302) 893-3717
Mailing address
1521 CONCORD PIKE, SUITE 301, WILMINGTON, DE 19803-3642
(302) 893-3717
(302) 416-5735
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0810001785
VA
103TC0700X
Clinical Psychologist
Primary
B1-0000699
DE
103TC0700X
Clinical Psychologist
PSY1628
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111917629
UNITED BEHAVIORAL HEALTH
—
01
—
21385
COMPSYCH
—
01
—
2270828
CIGNA
—
01
—
510387PSY
BLUE CROSS BLUE SHIELD
DE
01
—
7391402
AETNA
—
Enumeration date
08/31/2006
Last updated
03/13/2022
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