Provider Demographics
NPI:1902955438
Name:MARTIN, BARBARA JEAN (LBSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14900 LASATER RD
Mailing Address - Street 2:LOT 323
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75253-7623
Mailing Address - Country:US
Mailing Address - Phone:469-644-7733
Mailing Address - Fax:
Practice Address - Street 1:2504 RIDGE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2569
Practice Address - Country:US
Practice Address - Phone:972-768-9230
Practice Address - Fax:972-722-4087
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18975104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker