Provider Demographics
NPI:1609563592
Name:MARTELLY, CHRISTINE E (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:MARTELLY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 DOWNING SQ APT B
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-9404
Mailing Address - Country:US
Mailing Address - Phone:518-275-8061
Mailing Address - Fax:
Practice Address - Street 1:50 BEAVER ST STE 301
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-1504
Practice Address - Country:US
Practice Address - Phone:518-245-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health