Healthcare Provider Details

I. General information

NPI: 1235045998
Provider Name (Legal Business Name): ASHLEY RENE MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

9536 PENSTEMON CT
COLORADO SPRINGS CO
80920-3022
US

V. Phone/Fax

Practice location:
  • Phone: 719-524-4298
  • Fax:
Mailing address:
  • Phone: 719-359-7122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933697
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: