Provider Demographics
NPI:1215598651
Name:MARTINEZ, SUNNIE SHEARER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUNNIE
Middle Name:SHEARER
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 N SEMORAN BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3555
Mailing Address - Country:US
Mailing Address - Phone:407-206-1106
Mailing Address - Fax:
Practice Address - Street 1:1417 N SEMORAN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3555
Practice Address - Country:US
Practice Address - Phone:407-206-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW12674104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker