Provider Demographics
NPI:1760907729
Name:MARTINEFSKI, DESIRAE JUSTINE (LCSW, LAC)
Entity Type:Individual
Prefix:
First Name:DESIRAE
Middle Name:JUSTINE
Last Name:MARTINEFSKI
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7285 W MEXICO DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6910
Mailing Address - Country:US
Mailing Address - Phone:720-593-1258
Mailing Address - Fax:
Practice Address - Street 1:7285 W MEXICO DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6910
Practice Address - Country:US
Practice Address - Phone:720-593-1258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
1Other1