Provider Demographics
NPI:1366814170
Name:MARTIROS, ALENA (LMHC)
Entity type:Individual
Prefix:
First Name:ALENA
Middle Name:
Last Name:MARTIROS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-0544
Mailing Address - Country:US
Mailing Address - Phone:978-403-0248
Mailing Address - Fax:978-393-1252
Practice Address - Street 1:71 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1472
Practice Address - Country:US
Practice Address - Phone:978-403-0248
Practice Address - Fax:978-393-1252
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2021-03-02
Deactivation Date:2016-06-01
Deactivation Code:
Reactivation Date:2017-09-15
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA10202101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health