Provider Demographics
NPI:1962090597
Name:JULIE A MARTIN PLLC
Entity type:Organization
Organization Name:JULIE A MARTIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER AND PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-987-1344
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:
Practice Address - Street 1:600 HIGHWAY 133 # 22
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2516
Practice Address - Country:US
Practice Address - Phone:970-948-2267
Practice Address - Fax:970-704-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty