Provider Demographics
NPI:1043687320
Name:MARTINS, CRISTINA (MSW,BA,LCSW)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:MARTINS
Suffix:
Gender:F
Credentials:MSW,BA,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:54 S MAIN ST
Practice Address - Street 2:NEWTOWN CLINICALN SERVICES
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-5310
Practice Address - Country:US
Practice Address - Phone:203-270-5564
Practice Address - Fax:203-270-5514
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT77881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT5478849OtherCIGNA BEHAVIORAL HEALTH
CT13671438OtherCAQH
CT008061327Medicaid
CTPENDINGMedicare PIN
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CTPENDINGOtherVALUE OPTIONS
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
CT060669107OtherUBH-FREEDOM/LIBERTY OXFORD HEALTH WELLMORE GRP/FACILITY
CT13671438OtherCAQH
CTPENDINGOtherMHN TRICARE NORTH
CT060669107OtherUBH- CONNECTICARE WELLMORE GRP/FACILITY
CT5478849OtherCIGNA BEHAVIORAL HEALTH
CTPENDINGOtherMHN MANAGED HEALTH NETWORK