Provider Demographics
NPI:1245585439
Name:MARTINEZ, MELANIE ERIN (LPC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ERIN
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 1:201 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-1592
Mailing Address - Country:US
Mailing Address - Phone:719-241-3057
Mailing Address - Fax:719-241-3069
Practice Address - Street 1:201 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-1592
Practice Address - Country:US
Practice Address - Phone:719-241-3057
Practice Address - Fax:719-241-3069
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health