Provider Demographics
NPI:1720498702
Name:MARTINEZ, PERLA A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PERLA
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PERLA
Other - Middle Name:
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:602 BLUFFESTATES
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7968
Mailing Address - Country:US
Mailing Address - Phone:210-863-2124
Mailing Address - Fax:210-941-0886
Practice Address - Street 1:7272 WURZBACH RD STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4802
Practice Address - Country:US
Practice Address - Phone:210-863-2124
Practice Address - Fax:210-941-0886
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW116541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical