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LAKE MARTIN FAMILY THERAPY LLC NPI 1497904312


NPI Information

NPI: 1497904312
Provider Name: LAKE MARTIN FAMILY THERAPY, LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 01D0983317

Address:
393 GREEN ST
ALEXANDER CITY, AL
ZIP 35010
Phone: (256) 625-9514
Get Directions

LAKE MARTIN FAMILY THERAPY, LLC is a clinical social worker in Alexander City, AL. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. LAKE MARTIN FAMILY THERAPY, LLC NPI is 1497904312. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

393 GREEN ST
ALEXANDER CITY, AL
ZIP 35010-407
Phone: (256) 625-9514
Fax: (256) 825-6418

The provider's authorized official is Karen C. Lewis .
The authorized official title is Member/owner and has the following contact phone number (256) 625-9514.

The CLIA number assigned to this NPI record is 01D0983317 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/16/2008 and was last updated on 9/16/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1106H00000XMarriage & Family TherapistL 299ALABAMANo
21041C0700XSocial WorkerClinical2121CALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1L 299OTHERALABAMAALABAMA BOARD OF EXAMINERS IN MARRIAGE & FAMILY THERAPY
21652MEDICARE PINALABAMA
32121COTHERALABAMASTATE OF ALABAMA BOARD OF SOCIAL WORK EXMAINERS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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