Provider Demographics
NPI:1558721878
Name:MARTIN, CARIN S A (LCSW)
Entity type:Individual
Prefix:
First Name:CARIN
Middle Name:S A
Last Name:MARTIN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 EL CONTENTO DR
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3618
Mailing Address - Country:US
Mailing Address - Phone:479-426-8567
Mailing Address - Fax:
Practice Address - Street 1:223 EL CONTENTO DR
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3618
Practice Address - Country:US
Practice Address - Phone:479-426-8567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7805-C1041C0700X
AR7805-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker