Individual
MR. JOSHUA SHANE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC-I, MHPS, CHW
Contact information
Practice address
1125 JUDSON RD STE 150, LONGVIEW, TX 75601-5120
(903) 234-8755
(903) 234-8776
Mailing address
1125 JUDSON RD STE 150, LONGVIEW, TX 75601-5120
(903) 234-8755
(903) 234-8776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
54451
TX
172V00000X
Community Health Worker
9822
TX
175T00000X
Peer Specialist
1197-0120
TX
175T00000X
Peer Specialist
1814-0519
TX
175T00000X
Peer Specialist
50044-1120
TX
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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