Provider Demographics
NPI:1881588549
Name:MARTHA'S LIGHT RESOURCES AND SUPPORT FOR MOTHERS, INC.
Entity type:Organization
Organization Name:MARTHA'S LIGHT RESOURCES AND SUPPORT FOR MOTHERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:DHS, LCMHC-A, PMH-C
Authorized Official - Phone:919-297-8171
Mailing Address - Street 1:3248 PILSON RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-6487
Mailing Address - Country:US
Mailing Address - Phone:919-297-8171
Mailing Address - Fax:
Practice Address - Street 1:3248 PILSON RD
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-6487
Practice Address - Country:US
Practice Address - Phone:919-297-8171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty