Provider Demographics
NPI:1578262374
Name:MARTINO, KATE JENNIFER (LPC, NCC, CMPC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:JENNIFER
Last Name:MARTINO
Suffix:
Gender:F
Credentials:LPC, NCC, CMPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 GREEN VILLAGE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:GREEN VILLAGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07935-3027
Mailing Address - Country:US
Mailing Address - Phone:973-309-5802
Mailing Address - Fax:
Practice Address - Street 1:28 WETMORE AVE APT 3
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5266
Practice Address - Country:US
Practice Address - Phone:973-309-5802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00922000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00922000OtherNEW JERSEY DIVISION OF CONSUMER AFFAIRS