Provider Demographics
NPI:1154839413
Name:MARTINEZ, VERONICA (LPC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10015 BELFAST AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-2803
Mailing Address - Country:US
Mailing Address - Phone:915-373-3201
Mailing Address - Fax:
Practice Address - Street 1:201 W MAIN DR # 600
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1126
Practice Address - Country:US
Practice Address - Phone:915-887-3410
Practice Address - Fax:915-351-4703
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73761101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health