Provider Demographics
NPI:1023658960
Name:MARTINEZ, BARBARA ANGEL (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANGEL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4699 FOSSIL VISTA DR APT 5209
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76137-6214
Mailing Address - Country:US
Mailing Address - Phone:915-873-1287
Mailing Address - Fax:
Practice Address - Street 1:5424 RUFE SNOW DR STE 304
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6686
Practice Address - Country:US
Practice Address - Phone:817-576-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical