Provider Demographics
NPI:1619656055
Name:MARTINEZ WELLNESS, LLC
Entity Type:Organization
Organization Name:MARTINEZ WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:ROSARIO
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-429-9681
Mailing Address - Street 1:211 COUNTY ROAD A6
Mailing Address - Street 2:
Mailing Address - City:SAPELLO
Mailing Address - State:NM
Mailing Address - Zip Code:87745-5031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 COUNTY ROAD A6
Practice Address - Street 2:
Practice Address - City:SAPELLO
Practice Address - State:NM
Practice Address - Zip Code:87745-5031
Practice Address - Country:US
Practice Address - Phone:505-429-9681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty