MEDICARE: YAMISEL MARTINEZ-MOLINA LPC

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
1	101YP2500X	Professional Counselor	PC013887	PA

General Provider Information

NPI Number	:	1639836539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMISEL MARTINEZ-MOLINA LPC

Provider Business Mailing Address
First Line	:	150 RIDGE PIKE APT 211B
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-1917
Country	:	US
Telephone Number	:	717-769-7049
Fax Number	:

Provider Business Practice Location Address
First Line	:	752 WILLOW ST STE G
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17046-5066
Country	:	US
Telephone Number	:	484-269-6572
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2021
Last Update Date	:	01/13/2022

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