Provider Demographics
NPI:1861858474
Name:MARTINEZ, ELIZABETH CRISTINA (LCAS-A)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CRISTINA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WYNDHAM CIR
Mailing Address - Street 2:APT. B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-1663
Mailing Address - Country:US
Mailing Address - Phone:862-368-6893
Mailing Address - Fax:
Practice Address - Street 1:108 WYNDHAM CIR
Practice Address - Street 2:APT. B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-1663
Practice Address - Country:US
Practice Address - Phone:862-368-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)