Provider Demographics
NPI:1831494202
Name:ANASTACIA MARTINEZ, LPC, PC
Entity Type:Organization
Organization Name:ANASTACIA MARTINEZ, LPC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ANASTACIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:915-775-2599
Mailing Address - Street 1:3127 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-2502
Mailing Address - Country:US
Mailing Address - Phone:915-775-2599
Mailing Address - Fax:915-775-2584
Practice Address - Street 1:3127 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2502
Practice Address - Country:US
Practice Address - Phone:915-775-2599
Practice Address - Fax:915-775-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty