Martin, Michael Jack

Martin, Michael Jack is an sole proprietor health care provider with primary practice located at 175 W B St Ste C , Springfield OR 97477-4575. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Martin, Michael Jack can be contacted via phone (541) 423-2633.

Contact Information

Primary practice address
175 W B St Ste C Springfield OR 97477-4575
Phone: (541) 423-2633
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 70797 California
Behavioral Health & Social Service Providers / Mental Health 101YM0800X T2450 Oregon

Profile Details

NPI number 1912268384
LBN Legal business name Martin, Michael Jack
Credentials MA MFTI
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2012
Last updated Feb 9th, 2024 - about 2 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 1912268384 NPPES
California Other 70797 BBS

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