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General NPI Number Information
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NPI Number | 1407315658
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Entity Type | Individual
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Provider Name | DENISE MARTINEZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 13615 BAYVIEW ISLE DRIVE APT 301
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City | ORLANDO
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State | FL
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Zip | 32824
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Country | US
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Telephone | 407-440-1828
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 SIMPSON RD # 1012
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City | KISSIMMEE
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State | FL
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Zip | 34744-4604
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Country | US
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Telephone | 407-440-1828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH17917
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LMHC21569
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License Number State | FL
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