Provider Demographics
NPI:1487086542
Name:MARTINEZ, CARLOS E (LPC)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08242-1732
Mailing Address - Country:US
Mailing Address - Phone:609-827-7545
Mailing Address - Fax:
Practice Address - Street 1:128 CREST HAVEN RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1651
Practice Address - Country:US
Practice Address - Phone:609-778-6315
Practice Address - Fax:609-465-2588
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00474900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional