Provider Demographics
NPI:1841896719
Name:MARTINEZ, TATIANA (LCMHCA)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DUBLIN CT
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-0298
Mailing Address - Country:US
Mailing Address - Phone:812-369-3937
Mailing Address - Fax:
Practice Address - Street 1:70 WOODFIN PL STE 303
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2466
Practice Address - Country:US
Practice Address - Phone:812-369-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16103101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health