Provider Demographics
NPI:1427449156
Name:MARTIN, JANELLE ASHLY (LMFT122088)
Entity type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:ASHLY
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMFT122088
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 CAJON ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5903
Mailing Address - Country:US
Mailing Address - Phone:858-210-9399
Mailing Address - Fax:
Practice Address - Street 1:537 CAJON ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5903
Practice Address - Country:US
Practice Address - Phone:858-210-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT106829106H00000X
CALMFT122088106H00000X
101YM0800X, 106H00000X, 171M00000X
CA251B00000X, 324500000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251B00000XAgenciesCase Management
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program