Provider Demographics
NPI:1902322928
Name:ALVARADO, MARTINA GABRIELA (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:GABRIELA
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18826 SKY BLUE CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5398
Mailing Address - Country:US
Mailing Address - Phone:614-917-8156
Mailing Address - Fax:
Practice Address - Street 1:8945 N WESTLAND DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1249
Practice Address - Country:US
Practice Address - Phone:301-330-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health