Provider Demographics
NPI:1093515629
Name:MARTINEZ, JOE RAYMOND JR (LPC-A)
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:RAYMOND
Last Name:MARTINEZ
Suffix:JR
Gender:
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4634 SHINING WATERS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3345
Mailing Address - Country:US
Mailing Address - Phone:312-752-6797
Mailing Address - Fax:
Practice Address - Street 1:4204 GARDENDALE ST STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3138
Practice Address - Country:US
Practice Address - Phone:312-752-6797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health