Provider Demographics
NPI:1528470432
Name:MARTINEZ, CHRISTA (LMSW)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
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 1:9200 EDWARDS WAY APT 915
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3459
Mailing Address - Country:US
Mailing Address - Phone:316-993-5483
Mailing Address - Fax:405-286-1730
Practice Address - Street 1:9200 EDWARDS WAY APT 915
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-3459
Practice Address - Country:US
Practice Address - Phone:316-993-5483
Practice Address - Fax:405-286-1730
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKU/S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical