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NPI Code Detail

MEDICARE: DEREK MARTINEZ M. ED./ED. S.

MEDICARE: DEREK MARTINEZ M. ED./ED. S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor18291NC

General Provider Information

NPI Number : 1417404963
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK MARTINEZ M. ED./ED. S.
Provider Business Mailing Address
First Line : 157 RIVERVIEW DR
Second Line :
City : ASHEVILLE
State : NC
Zip : 28806-4503
Country : US
Telephone Number : 813-728-3113
Fax Number :
Provider Business Practice Location Address
First Line : 322 8TH AVE E
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28792-3713
Country : US
Telephone Number : 828-708-7088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2016
Last Update Date : 04/09/2025

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