| Martin Model, Lcsw, Pc | |
|
40594 Road G Mancos CO 81328-8927 | |
| (970) 533-7816 | |
| Not Available |
| Full Name | Martin Model, Lcsw, Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 40594 Road G, Mancos, Colorado |
| Authorized Official Name and Position | Martin Model (PRESIDENT) |
| Authorized Official Contact | 9705337816 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Model, Lcsw, Pc 40594 Road G Mancos CO 81328-8927 Ph: (970) 533-7816 | Martin Model, Lcsw, Pc 40594 Road G Mancos CO 81328-8927 Ph: (970) 533-7816 |
| NPI Number | 1033251376 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033251376 | NPI | - | NPPES |
| 07983018 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 983015 (Colorado) | Primary |
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