Provider Demographics
NPI:1205506854
Name:MARTINEZ, STEPHANIE (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 EDISTO CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1671
Mailing Address - Country:US
Mailing Address - Phone:919-360-0396
Mailing Address - Fax:
Practice Address - Street 1:288 EAST ST STE 1001-F7
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9711
Practice Address - Country:US
Practice Address - Phone:919-704-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0135411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical