Provider Demographics
NPI:1760169965
Name:GARZA, MARTINA (LMHC LIMITED PERMIT)
Entity Type:Individual
Prefix:
First Name:MARTINA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:LMHC LIMITED PERMIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 TOWER DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1014
Mailing Address - Country:US
Mailing Address - Phone:516-749-3266
Mailing Address - Fax:
Practice Address - Street 1:14 WALL ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-2101
Practice Address - Country:US
Practice Address - Phone:646-685-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health