Martin, Connie Ann

Martin, Connie Ann is an individual health care provider with primary practice located at 2466 S 48Th St , Springdale AR 72762-6683. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Martin, Connie Ann can be contacted via phone (479) 750-2020.

Contact Information

Primary practice address
2466 S 48Th St Springdale AR 72762-6683
Phone: (479) 750-2020
Fax: (479) 750-2747
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X P0501006 Arkansas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X M05001003 Arkansas

Profile Details

NPI number 1275576167
LBN Legal business name Martin, Connie Ann
Credentials LPC LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275576167 NPPES
Arizona Other 5Y342 BLUE SHIELD PROVIDER#

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