KENNETH LEON MARTIN


Address: 105 Paces Brook Ave, #10518, Columbia, SC 29212-1642
Phone: 8034674125

KENNETH LEON MARTIN (NPI# 1093899007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093899007
Entity Type Individual
Full Name KENNETH LEON MARTIN
Credential MA, LPC
Practice Address 105 Paces Brook Ave
#10518
Columbia
SC 29212-1642
Mailing Address 105 Paces Brook Ave
Apt 10518
Columbia
SC 29212-1642
Practice Telephone 8034674125
Practice Fax Number 8034973920
Mailing Telephone 8034674125
Mailing Fax Number 8034973920
Enumeration Date 2006-10-25
Last Update Date 2011-09-06
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
4941 SC Behavioral Health & Social Service Providers

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Office Location

Street Address 105 PACES BROOK AVE
#10518
City COLUMBIA
State SC
Zip Code 29212-1642

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417341611 Fullcircle Counseling Service and Consultation Counselor 105 Paces Brook Ave, #518, Columbia, SC 29212-1642 2015-03-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245758887 Amanda Gail Holloman Pharmacist 6021 St. Andrews Road, Columbia, SC 29212 2017-09-04
1578080180 Alvin Mitchell Jr. Non-emergency Medical Transport (VAN) 10 Breezewood Court, Columbia, SC 29212 2017-08-24
1467975102 Shelby Clemmer Behavior Technician 2 Harbison Way, Columbia, SC 29212 2017-07-25
1982149019 Showntellem Private Vehicle 336 Foxfire Dr, Columbia, SC 29212 2016-12-28
1902215296 Miranda Willis Adult Day Care, LLC Social Worker 5932 Mcmillian Circle, Columbia, SC 29212 2014-08-12
1013342591 Robert Glendon Long Pediatrics 15 Woodpine Ct, Columbia, SC 29212 2013-09-04
1174969638 Melinda Dumas Crenshaw Psychologist 2800 Ashland Rd., Columbia, SC 29212 2013-05-10
1417209982 Physician Services LLC Internal Medicine 214 Lake Front Drive, Physician Services, Cola, SC 29212 2012-10-09
1306131800 Rocky Mountain Holdings LLC Ambulance 6015 Saint Andrews Rd, Columbia, SC 29212 2011-06-13
1023262839 Candace Anne Aguiar Nurse Anesthetist, Certified Registered 400 Palmetto Health Pkwy, Palmetto Health Baptist Parkridge, Columbia, SC 29212 2008-11-06
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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1477151538 Gabriela Rios-martinez Counselor 10310 Swift Stream Pl Apt 405, Columbia, MD 21044-4899 2020-10-12
1508470840 Christine Schaub Counselor 214 Autumn Run Cir, Columbia, SC 29229-7622 2020-09-03
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1083224828 Elite Transformant Solutions Counselor 6701 Bailey St, Columbia, SC 29203-7454 2020-08-06
1083223671 Grant B Counseling & Consultation, LLC Counselor 702 Wildlife Ln, Columbia, SC 29209-3464 2020-07-29
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Competitor

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City COLUMBIA
Zip Code 29212

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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