Provider Demographics
NPI:1447768924
Name:SANCHEZ, MARTHA L (LMSW)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:L
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:MARTHA
Other - Middle Name:L
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:630 HAINES AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1226
Mailing Address - Country:US
Mailing Address - Phone:505-268-5611
Mailing Address - Fax:505-268-5736
Practice Address - Street 1:630 HAINES AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1226
Practice Address - Country:US
Practice Address - Phone:505-268-5611
Practice Address - Fax:505-268-5736
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0119281101YA0400X
NMM-10875104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)