Provider Demographics
NPI:1811683683
Name:MARTONIS, AMY LYNN (MSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:MARTONIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 FERRYBOAT CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-7925
Mailing Address - Country:US
Mailing Address - Phone:970-999-2287
Mailing Address - Fax:
Practice Address - Street 1:150 E 29TH ST STE 215
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2765
Practice Address - Country:US
Practice Address - Phone:970-999-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00000009741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical