Provider Demographics
NPI:1841733599
Name:MARTINEZ, MONICA MARIA (LCSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIA
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 1:7717 NARDO GOODMAN DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-8441
Mailing Address - Country:US
Mailing Address - Phone:915-820-3150
Mailing Address - Fax:
Practice Address - Street 1:7717 NARDO GOODMAN DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-8441
Practice Address - Country:US
Practice Address - Phone:915-820-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX505661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical