Individual
KENNETH J MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1020 S MAIN ST, SALT LAKE CITY, UT 84101-3176
(801) 539-7000
Mailing address
1020 S MAIN ST, SUITE 100, SALT LAKE CITY, UT 84101-3176
(801) 539-7035
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1406413501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003104013
RAILROAD MEDICARE
UT
01
—
107001385101
INTRMTN HEALTH CARE
UT
01
—
261919
DESERET MUTUAL
UT
01
—
942938348
CHAMPUS
UT
01
—
942938348MA2
EDUCATORS MUTUAL
UT
01
—
R79728
MEDICARE ADVANTAGE PLANS
UT
01
—
X
BLUE CROSS
UT
Enumeration date
01/26/2006
Last updated
05/10/2022
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