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NPI Code Detail

MEDICARE: JON SEBASTIAN MARTINEZ

MEDICARE: JON SEBASTIAN MARTINEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor11318125WI
2101YM0800XMental Health Counselor87416TX

General Provider Information

NPI Number : 1144930868
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON SEBASTIAN MARTINEZ
Provider Business Mailing Address
First Line : 1686 BIRCHWOOD DR
Second Line :
City : GREEN BAY
State : WI
Zip : 54304-2937
Country : US
Telephone Number : 956-206-1130
Fax Number :
Provider Business Practice Location Address
First Line : 610 N BROADWAY
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3426
Country : US
Telephone Number : 956-206-1130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2022
Last Update Date : 09/19/2025

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Directions to “ JON SEBASTIAN MARTINEZ ” Practice Location

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