National Provider Identifier
Ethan Martinez
Ethan Martinez is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Lockport, NY and a listed phone number of (716) 345-7066.
Profile Overview
- NPI
- 1689497778
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- November 06, 2024
- Last Updated
- November 06, 2024
Practice Location
- 6395 Old Niagara RD
- Lockport, NY 14094-1421
Phone: (716) 345-7066
Specialties
- Mental Health Counselor (101YM0800X)
Full Record
- NPI
- 1689497778
- Entity Type
- Individual
- Last Name
- Martinez
- First Name
- Ethan
- Mailing Street Address
- 6395 Old Niagara RD
- Mailing City
- Lockport
- Mailing State
- NY
- Mailing ZIP Code
- 14094-1421
- Mailing Country
- US
- Mailing Phone
- (716) 345-7066
- Mailing Fax
- (716) 303-7505
- Practice Street Address
- 6395 Old Niagara RD
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-1421
- Practice Country
- US
- Practice Phone
- (716) 345-7066
- Practice Fax
- (716) 303-7505
- Enumeration Date
- November 06, 2024
- Last Updated
- November 06, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- November 06, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X)