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Contact Information

DOUGLASS E MARTIN, ED.D.
4013 NE 57TH PL
GLADSTONE, MO64119-2268
 Phone: 816-536-1828
 Fax: 816-413-5305
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DOUGLASS E MARTIN · (Male)

NPI Number 1649357211
Status Active
Credentials ED.D.
Entity Individual
Enumeration date 11/01/2006
Last updated 01/20/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # PY000307
  • MO Other 16469011 BC/BS PROVIDER #
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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