Provider Demographics
NPI:1326484486
Name:MARTINEZ, ALYSON JOANNE (LCADC, LCSW)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:JOANNE
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:LCADC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 W BONANZA RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3227
Mailing Address - Country:US
Mailing Address - Phone:702-846-7941
Mailing Address - Fax:702-382-1766
Practice Address - Street 1:480 W BONANZA RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3227
Practice Address - Country:US
Practice Address - Phone:702-846-7941
Practice Address - Fax:702-382-1766
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00580-LC101YA0400X
NVIC-10811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV00580-LCOtherBOARD OF EXAMINERS FOR ALCOHOL, DRUG AND GAMBLING COUNSELORS
NV8697-COtherSTATE OF NV BOARD OF EXAMINERS FOR SOCIAL WORKERS