Provider Demographics
NPI:1144545138
Name:MARTINEZ-AGUILAR, JULIE ANNETTE (MSW, LICSW)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANNETTE
Last Name:MARTINEZ-AGUILAR
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:ANNETTE
Other - Last Name:WORKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:198 MORGANTOWN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BRUCETON MILLS
Mailing Address - State:WV
Mailing Address - Zip Code:26525-5003
Mailing Address - Country:US
Mailing Address - Phone:304-379-7600
Mailing Address - Fax:301-533-3299
Practice Address - Street 1:198 MORGANTOWN ST STE 2
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525-5003
Practice Address - Country:US
Practice Address - Phone:304-379-7600
Practice Address - Fax:301-533-3299
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009433551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810028820Medicaid
WVQ49621AMedicare PIN