Provider Demographics
NPI:1326484486
Name:MARTINEZ, ALYSON JOANNE (MSW, LADC, CSW-I)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:JOANNE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MSW, LADC, CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S MARTIN LUTHER KING BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4313
Mailing Address - Country:US
Mailing Address - Phone:702-290-3222
Mailing Address - Fax:702-385-5519
Practice Address - Street 1:2255 RENAISSANCE DR STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6194
Practice Address - Country:US
Practice Address - Phone:702-451-7542
Practice Address - Fax:702-450-4239
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NVIC-10811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVIC-1081OtherSTATE OF NV BOARD OF EXAMINERS FOR SOCIAL WORKERS