Provider Demographics
NPI:1295194355
Name:MARTINEZ, AIDA L (LMHC)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:L
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 131ST ST APT 7J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-3481
Mailing Address - Country:US
Mailing Address - Phone:347-804-4206
Mailing Address - Fax:
Practice Address - Street 1:200 E 131ST ST APT 7J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-3481
Practice Address - Country:US
Practice Address - Phone:347-804-4206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY010357-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health