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NPI Code Detail

MEDICARE: CRISTIN R MARTINEZ MS, LPC

MEDICARE: CRISTIN R MARTINEZ MS, 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
1101YP2500XProfessional Counselor2010009691MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942523493
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTIN R MARTINEZ MS, LPC
Provider Business Mailing Address
First Line : 1300 E BRADFORD PKWY
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-4264
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5011
Provider Business Practice Location Address
First Line : 323 E GRAND ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-1447
Country : US
Telephone Number : 417-761-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2010
Last Update Date : 03/22/2019

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