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General NPI Number Information
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NPI Number | 1740356377
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Entity Type | Individual
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Provider Name | CARMEN MARTINEZ TITTMANN MA LPCC LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4686 CORRALES RD
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City | CORRALES
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State | NM
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Zip | 87048
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Country | US
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Telephone | 505-890-3327
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Fax | 505-898-6327
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Provider Business Mailing Address
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Address Line | PO BOX 3204
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City | CORRALES
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State | NM
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Zip | 87048
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Country | US
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Telephone | 505-890-3327
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Fax | 505-898-6327
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1587
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | M2126
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1587
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License Number State | NM
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