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General NPI Number Information
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NPI Number | 1457831448
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Entity Type | Individual
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Provider Name | LAURA E MARTINEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/19/2018
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 9420 LINDALE AVE
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City | BATON ROUGE
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State | LA
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Zip | 70815-4161
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Country | US
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Telephone | 225-442-3540
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Fax |
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Provider Business Mailing Address
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Address Line | 465 MAGNOLIA WOOD AVE
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City | BATON ROUGE
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State | LA
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Zip | 70808-6828
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Country | US
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Telephone | 225-328-6897
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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 | 12810
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12810
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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