Eva Diane Martin, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC001690 Issued in GA

Practice address

2920 Marietta Highway
Suite 146
Canton, GA 30114

Phone

(470) 253-7252

Fax

(800) 397-1710

NPI assigned

Jan 10, 2011

Last updated

Jan 26, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1326342098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 MARIETTA HIGHWAY",
            "address_2": "SUITE 146",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "470-253-7252",
            "fax_number": "800-397-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MARIETTA HIGHWAY",
            "address_2": "SUITE 146",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "470-253-7252",
            "fax_number": "800-397-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EVA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC001690",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "GA",
            "license": "LPC001690",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "LPC001690",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003106189B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Parker Marks Jr., M.D.
• Justin Marlow
• Kira Lynne Marquez
• David L Marshall, D.C.
• Laurie Croff Marsolo, LDO
• Michelle L Martin, LPC
• Todd C Martin, M.D.
• Whitley Martin, RBT
• Michael Anthony Martinelli, M.D.
• Katelyn Victoria Martino, CCC-M.ED. SLP

• Professional Counselor in Canton, GA
• Providers in Canton, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.