Provider Demographics
NPI:1407315658
Name:MARTINEZ, DENISE (LMHC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
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 1:1431 SIMPSON RD # 1012
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4604
Mailing Address - Country:US
Mailing Address - Phone:407-440-1828
Mailing Address - Fax:
Practice Address - Street 1:13615 BAYVIEW ISLE DRIVE
Practice Address - Street 2:APT 301
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824
Practice Address - Country:US
Practice Address - Phone:407-440-1828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH17917101YM0800X
FLLMHC21569101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLLMHC21569OtherLICENSED MENTAL HEALTH COUNSELOR
FLIMH17917OtherREGISTERED MENTAL HEALTH COUNSELOR INTERN