Provider Demographics
NPI:1346917127
Name:MARTINEZ, VERONICA A (LSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:A
Last Name:MARTINEZ
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 1:710 17TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-6740
Mailing Address - Country:US
Mailing Address - Phone:201-320-9954
Mailing Address - Fax:
Practice Address - Street 1:15 WARREN ST STE 20
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5436
Practice Address - Country:US
Practice Address - Phone:201-320-9954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06676100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty