Provider Demographics
NPI:1922814011
Name:MARTINEZ, STEPHANIE ASHLEY (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ASHLEY
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E SAN ANTONIO ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5568
Mailing Address - Country:US
Mailing Address - Phone:512-596-5805
Mailing Address - Fax:
Practice Address - Street 1:100 E SAN ANTONIO ST STE 101
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5568
Practice Address - Country:US
Practice Address - Phone:512-596-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical