Provider Demographics
NPI:1447768924
Name:SANCHEZ, MARTHA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:MARTHA
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1615 OJO COURT
Mailing Address - Street 2:TOTAH BEHAVIORAL HEA;TH AUTHORITY
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401
Mailing Address - Country:US
Mailing Address - Phone:505-564-4804
Mailing Address - Fax:505-564-4857
Practice Address - Street 1:3230 WARING CT STE A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4509
Practice Address - Country:US
Practice Address - Phone:760-305-7528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0119281101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)