1326484486 NPI number — ALYSON JOANNE MARTINEZ LCADC, LCSW

Table of content: ALYSON JOANNE MARTINEZ LCADC, LCSW (NPI 1326484486)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326484486 NPI number — ALYSON JOANNE MARTINEZ LCADC, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARTINEZ
Provider First Name:
ALYSON
Provider Middle Name:
JOANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCADC, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326484486
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
480 W BONANZA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89106-3227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-846-7941
Provider Business Mailing Address Fax Number:
702-382-1766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
480 W BONANZA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89106-3227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-846-7941
Provider Business Practice Location Address Fax Number:
702-382-1766
Provider Enumeration Date:
05/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  00580-LC , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00580-LC . This is a "BOARD OF EXAMINERS FOR ALCOHOL, DRUG AND GAMBLING COUNSELORS" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 8697-C . This is a "STATE OF NV BOARD OF EXAMINERS FOR SOCIAL WORKERS" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com