Healthcare Provider Details

I. General information

NPI: 1881517464
Provider Name (Legal Business Name): JOSEPH SAMUEL MARTINEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 TURNER RD
NORTH CHESTERFIELD VA
23224-2537
US

IV. Provider business mailing address

7133 OMALLEY DR
NORTH CHESTERFIELD VA
23234-2880
US

V. Phone/Fax

Practice location:
  • Phone: 804-276-6059
  • Fax:
Mailing address:
  • Phone: 804-895-0768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: