Provider Demographics
NPI:1871305490
Name:MARTINEZ, FELIX LUIS JR (LMSW)
Entity type:Individual
Prefix:MR
First Name:FELIX
Middle Name:LUIS
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 PLANK RD STE 111
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4886
Mailing Address - Country:US
Mailing Address - Phone:347-639-7142
Mailing Address - Fax:
Practice Address - Street 1:636 PLANK RD STE 111
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-4886
Practice Address - Country:US
Practice Address - Phone:347-639-7142
Practice Address - Fax:929-322-9200
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126453104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty