Provider Demographics
NPI:1467110742
Name:CASTRO MARTINEZ, SANDRA L (MS LCMHC-A, LCAS-A)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:L
Last Name:CASTRO MARTINEZ
Suffix:
Gender:F
Credentials:MS LCMHC-A, LCAS-A
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS LCMHC-A, LCAS-A
Mailing Address - Street 1:1944 SOMERSET HILLS CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-8442
Mailing Address - Country:US
Mailing Address - Phone:919-614-4586
Mailing Address - Fax:
Practice Address - Street 1:1944 SOMERSET HILLS CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-8442
Practice Address - Country:US
Practice Address - Phone:919-614-4586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27375101YA0400X
NCA17370101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)