Provider Demographics
NPI:1609167451
Name:MARTINEZ, NORIKO I (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:NORIKO
Middle Name:I
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SKOKIE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4039
Mailing Address - Country:US
Mailing Address - Phone:847-372-8134
Mailing Address - Fax:
Practice Address - Street 1:801 SKOKIE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4039
Practice Address - Country:US
Practice Address - Phone:847-372-8134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0128241041C0700X
MI68011041281041C0700X
COCSW.099258651041C0700X
INCV210008371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical