Organization
JANICE MARTIN LICENSED CLINICAL SOCIAL WORKER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE M MARTIN LCSW (PRESIDENT)
(631) 680-7222
Entity
Organization
Contact information
Practice address
710 MAIN ST, PORT JEFFERSON, NY 11777-2278
(631) 680-7222
Mailing address
PO BOX 433, PORT JEFFERSON, NY 11777-0433
(631) 680-7222
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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