| Carroll Martin Lcsw - Llc | |
|
41631 Olivine Pl Aldie VA 20105-5682 | |
| (703) 775-4102 | |
| Not Available |
| Full Name | Carroll Martin Lcsw - Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 41631 Olivine Pl, Aldie, Virginia |
| Authorized Official Name and Position | Carroll Martin (OWNER / CEO) |
| Authorized Official Contact | 5404061717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carroll Martin Lcsw - Llc 41631 Olivine Pl Aldie VA 20105-5682 Ph: (703) 775-4102 | Carroll Martin Lcsw - Llc 41631 Olivine Pl Aldie VA 20105-5682 Ph: (703) 775-4102 |
| NPI Number | 1659039121 |
|---|---|
| Provider Enumeration Date | 12/02/2021 |
| Last Update Date | 12/02/2021 |
| Certification Date | 11/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659039121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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