Provider Demographics
NPI:1225191141
Name:MARTINEZ, MARGARITA T (LPC)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:T
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 1:8306 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-3102
Mailing Address - Country:US
Mailing Address - Phone:806-252-7275
Mailing Address - Fax:806-747-3219
Practice Address - Street 1:5701 AVENUE P
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412
Practice Address - Country:US
Practice Address - Phone:806-252-7275
Practice Address - Fax:806-747-3219
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62510101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health