Provider Demographics
NPI:1912455411
Name:MARTINE LUNTZ
Entity Type:Organization
Organization Name:MARTINE LUNTZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-243-9970
Mailing Address - Street 1:101 SUE ANN CT
Mailing Address - Street 2:APT A
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1346
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 SUE ANN CT
Practice Address - Street 2:APT A
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1346
Practice Address - Country:US
Practice Address - Phone:954-243-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4972103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty