Provider Demographics
NPI:1982166575
Name:MARTINEZ, ERIN KATHARINE (LMSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHARINE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N THORNTON ST STE H
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-5508
Mailing Address - Country:US
Mailing Address - Phone:575-935-4411
Mailing Address - Fax:575-935-0400
Practice Address - Street 1:1200 N THORNTON ST STE H
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-5508
Practice Address - Country:US
Practice Address - Phone:575-935-4411
Practice Address - Fax:575-935-0400
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-010234104100000X
CT0117001041C0700X
NMC-112871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker