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Individual
KEITH H MARTINEZ
Active
Individual
KEITH H MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00155000
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05187400
NJ
Other
Enumeration date
12/30/2012
Last updated
03/27/2013
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