Provider Demographics
NPI:1891514972
Name:JOSE R MARTINEZ LICENSED MENTAL HEALTH COUNSELOR
Entity type:Organization
Organization Name:JOSE R MARTINEZ LICENSED MENTAL HEALTH COUNSELOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE R MARTINEZ
Authorized Official - Middle Name:RAPHAEL
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-727-0152
Mailing Address - Street 1:69 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4336
Mailing Address - Country:US
Mailing Address - Phone:914-727-0152
Mailing Address - Fax:
Practice Address - Street 1:69 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4336
Practice Address - Country:US
Practice Address - Phone:914-727-0152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty