Provider Demographics
NPI:1073169215
Name:MARTZ, HEATHER CAMERON (LSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CAMERON
Last Name:MARTZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E SPEER BLVD STE 219
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3719
Mailing Address - Country:US
Mailing Address - Phone:720-988-4293
Mailing Address - Fax:
Practice Address - Street 1:825 E SPEER BLVD STE 219
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3719
Practice Address - Country:US
Practice Address - Phone:720-988-4293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009921096104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker