Vanessa Marie Martinez, TCADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Jeffersontown, KY

NPI 1669232245 · NPPES record last updated Mar 20, 2024

Key facts

NPI
1669232245
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
282011 (KY)
Practice address
1700 Cargo CT
Jeffersontown, KY 40299-1938
Phone
(800) 805-6989
NPI assigned
Mar 20, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
282011KYMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 282011 KY Yes

Addresses

Primary practice location

1700 Cargo CT
Jeffersontown, KY 40299-1938

Mailing address

2314 Pikes Peak Blvd
Louisville, KY 40214-1160
Phone (270) 243-7609

Other providers in Jeffersontown, KY

All providers in Jeffersontown, KY · Addiction (Substance Use Disorder) Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.