Provider Demographics
NPI:1548902836
Name:MARTINEZ COUNSELING, LLC
Entity type:Organization
Organization Name:MARTINEZ COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER620-
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:620-664-3901
Mailing Address - Street 1:405 CRESCENT BLVD
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-5515
Mailing Address - Country:US
Mailing Address - Phone:620-664-3901
Mailing Address - Fax:
Practice Address - Street 1:127 E AVENUE B STE B
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-7463
Practice Address - Country:US
Practice Address - Phone:620-960-7822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health