Provider Demographics
NPI:1730373523
Name:MARTIN, JULIE A (MA, LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 964
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-0964
Mailing Address - Country:US
Mailing Address - Phone:970-948-2267
Mailing Address - Fax:970-704-6233
Practice Address - Street 1:995 COWEN DR UNIT 203
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1657
Practice Address - Country:US
Practice Address - Phone:970-948-2267
Practice Address - Fax:970-704-6233
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health