Provider Demographics
NPI:1669365615
Name:MARTINEZ, ERIC DANIEL (MA, MA, LPC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:DANIEL
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MA, MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 MARY DELL DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-7436
Mailing Address - Country:US
Mailing Address - Phone:806-236-2480
Mailing Address - Fax:806-354-8236
Practice Address - Street 1:5609 MARY DELL DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-7436
Practice Address - Country:US
Practice Address - Phone:806-236-2480
Practice Address - Fax:806-354-8236
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020823101YP2500X
TX86722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional