Provider Demographics
NPI:1568748028
Name:MARTIN, VALERIE JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:HYATT
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3800 MAHONIA WAY APT 2035
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-4265
Mailing Address - Country:US
Mailing Address - Phone:682-433-1706
Mailing Address - Fax:
Practice Address - Street 1:3800 MAHONIA WAY APT 2035
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-4265
Practice Address - Country:US
Practice Address - Phone:682-433-1706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical