Provider Demographics
NPI:1497996235
Name:MARTINEZ, ADRIANA (LPC)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 GLENWOOD SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1122
Mailing Address - Country:US
Mailing Address - Phone:281-813-4158
Mailing Address - Fax:
Practice Address - Street 1:514 1ST ST E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4605
Practice Address - Country:US
Practice Address - Phone:281-813-4158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61848101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD10138045Medicaid