Provider Demographics
NPI:1144524158
Name:MARTINEZ, LORI ELLEN (LMHC, LCMHC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ELLEN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMHC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2148 PICCADILLY CIRCUS
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-3681
Mailing Address - Country:US
Mailing Address - Phone:239-961-0284
Mailing Address - Fax:
Practice Address - Street 1:2148 PICCADILLY CIRCUS
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-3681
Practice Address - Country:US
Practice Address - Phone:239-961-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8385101YP2500X
FLMH23330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional