MR. MICHAEL IANN MARTIN - NPI 1063016772 - Counselor in Ketchikan, AK

Q: What is Michael Martin's NPI number?

The NPI number for Michael Martin is 1063016772. It was assigned to this individual provider in the NPPES registry on November 23, 2020.

Q: What is Michael Martin's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Michael Martin was last updated on November 23, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mr. Michael Iann Martin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MICHAEL IANN MARTIN (NPI 1063016772) is an individual mental health provider in Ketchikan, Alaska and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1063016772

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. MICHAEL IANN MARTIN

Location Address2514 FIRST AVEKetchikan, AK 99901-5804

Mailing AddressPo Box 7475Ketchikan, AK 99901-2475 · (907) 821-8119 · Fax (907) 885-6613

Phone(907) 821-8119

Fax(907) 885-6613

Sole ProprietorNo

Enumeration DateNovember 23, 2020

NPPES CertifiedNovember 23, 2020

✔ NPI 1063016772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

2514 FIRST AVE, Ketchikan, AK 99901

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Other Identifiers 2

Medicaid1021118AK

Medicaid1584706AK

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JAMES EDWARD MCDONALD JR.

Counselor (Mental Health)