Provider Demographics
NPI:1124000302
Name:ADAME, MARTHA ELENA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:ELENA
Last Name:ADAME
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:MARTHA
Other - Middle Name:ADAME
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:508 S MON MACK RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6577
Mailing Address - Country:US
Mailing Address - Phone:956-287-8741
Mailing Address - Fax:
Practice Address - Street 1:905 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6616
Practice Address - Country:US
Practice Address - Phone:956-618-4648
Practice Address - Fax:956-686-4377
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19324101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1718272Medicaid