Provider Demographics
NPI:1720557986
Name:MARTELL, MICHELLE ANITA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANITA
Last Name:MARTELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 WHISPERING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918
Mailing Address - Country:US
Mailing Address - Phone:914-261-7686
Mailing Address - Fax:
Practice Address - Street 1:90 E MAIN STREET SUITE # 201
Practice Address - Street 2:
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992
Practice Address - Country:US
Practice Address - Phone:914-261-7686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health