Provider Demographics
NPI:1538279492
Name:MARTINELLI, PATRICIA RAE (MS LMHC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:RAE
Last Name:MARTINELLI
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 94TH PL SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3050
Mailing Address - Country:US
Mailing Address - Phone:425-337-9055
Mailing Address - Fax:
Practice Address - Street 1:2802 94TH PL SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3050
Practice Address - Country:US
Practice Address - Phone:425-337-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010640101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health