Doctor Name: | MR. MICHAEL C MARTINEZ |
NPI Number: | 1376890756 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.P.C. |
License Number: | 180008233 |
Business Practice Address: | 3808 W Irving Park Rd Chicago, IL - 606183140 |
Business Phone Number: | 7739469599 |
Business Fax Number: | |
Mailing Address: | 3963 W Belmont Ave Unit 210, CHICAGO |
State: | IL |
Postal Code: | 606184339 |
Phone Number: | 7739469599 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2012 |
NPI Last Update Date: | 08/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 180008233 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |