Provider Demographics
NPI:1316084247
Name:STANLEY-MARTINEZ, CHRISTINA YVETTE (LMHC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:YVETTE
Last Name:STANLEY-MARTINEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 AIRPORT RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-8114
Mailing Address - Country:US
Mailing Address - Phone:978-343-0794
Mailing Address - Fax:978-665-2976
Practice Address - Street 1:270 AIRPORT RD
Practice Address - Street 2:SUITE D
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-8114
Practice Address - Country:US
Practice Address - Phone:978-343-0794
Practice Address - Fax:978-665-2976
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3875101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health