Martha Thomas Land, BCCC
Individual provider Active NPI Counselor · Avondale Estates, GA
NPI 1801147194 · NPPES record last updated Sep 26, 2012
Key facts
- NPI
- 1801147194
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 08129747 (GA)
- Practice address
- 562 Stratford GRN
Avondale Estates, GA 30002-1354 - Phone
- (770) 841-9539
- NPI assigned
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08129747 | GA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 08129747 | GA | Yes |
Addresses
Primary practice location
562 Stratford GRN
Avondale Estates, GA 30002-1354
Mailing address
562 Stratford GRN
Avondale Estates, GA 30002-1354
Phone (770) 841-9539
Other providers in Avondale Estates, GA
- Philip Joshua Haun
- Stefanie Elizabeth Hays
- Catherine L Johnson
- Donna M Kelley
- Janice Koiki
- Danielle Larkin
- Elizabeth Connors Leonard
- Living in the Light Wellness
- Brian Odell Love-El
- Lucretia Dubose Psychotherapy
All providers in Avondale Estates, GA · Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.