Provider Demographics
NPI:1962741827
Name:MARTINEZ, ALLISON B (LCSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:B
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 GREENWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-0000
Mailing Address - Country:US
Mailing Address - Phone:215-715-6946
Mailing Address - Fax:
Practice Address - Street 1:521 GREENWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-0000
Practice Address - Country:US
Practice Address - Phone:215-715-6946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0175091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical