IndividualActive
Lisa Martin, LCSW
NPI 1417002197 · Clinical Social Worker · Patrick Afb, FL
Provider details
- NPI number
- 1417002197
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- SW2979 (FL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1370 Patrick Dr
Patrick Afb, FL 32925-3606
Phone: (321) 494-8234
Fax: (321) 494-8074
Approximate (ZIP-level) locationGet directions
Mailing address
455 Indian Creek Dr
Cocoa Beach, FL 32931-2833
Registry dates
- Enumerated
- 2007-01-24
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.