Healthcare Provider Details

I. General information

NPI: 1487579348
Provider Name (Legal Business Name): LEXI MARTINEZ MPS, LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11107 ULYSSES ST NE STE 100
BLAINE MN
55434-4264
US

IV. Provider business mailing address

11426 HAZELWOOD LN N
CHAMPLIN MN
55316-1935
US

V. Phone/Fax

Practice location:
  • Phone: 763-333-7733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306422
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5752
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: