Healthcare Provider Details

I. General information

NPI: 1548738461
Provider Name (Legal Business Name): MARLENY G LEMUS MARTINEZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 WHITE PLAINS RD STE 100
TARRYTOWN NY
10591-5172
US

IV. Provider business mailing address

660 WHITE PLAINS RD STE 100
TARRYTOWN NY
10591-5172
US

V. Phone/Fax

Practice location:
  • Phone: 914-332-1300
  • Fax:
Mailing address:
  • Phone: 914-332-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number014589
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: