Provider Demographics
NPI:1720392749
Name:MARTIN, VALERIE MARIE (LISW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 LAFAYETTE CT
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-1505
Mailing Address - Country:US
Mailing Address - Phone:859-609-7208
Mailing Address - Fax:
Practice Address - Street 1:4237 LAFAYETTE CT
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1505
Practice Address - Country:US
Practice Address - Phone:859-609-7208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.15024591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical