Individual provider Active NPI

Audrey May Lujan-Gantz, BCBA

  • Behavior Analyst
  • Albuquerque, NM
National Provider Identifier
1063889715
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-58035 Issued in NU
Practice address
5200 Pasadena Ave NE Unit F
Albuquerque, NM 87113-2208
Phone
(505) 856-6880
NPI assigned
Aug 28, 2015
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 2677 NC
Behavior Analyst 103K00000X 1-22-58035 NU Primary

Addresses

Primary practice location

5200 Pasadena Ave NE Unit F
Albuquerque, NM 87113-2208

Mailing address

5200 Pasadena Ave NE Unit F
Albuquerque, NM 87113-2208
Phone (505) 856-6880

Other practice location 1

1649 61st Street
St 301 3rd floor
Brooklyn, NY 11204
Phone (505) 715-9616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2677NCMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1063889715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 PASADENA AVE NE UNIT F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132208",
            "telephone_number": "505-856-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PASADENA AVE NE UNIT F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132208",
            "telephone_number": "505-856-6880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1649 61st Street",
            "address_2": "St 301 3rd floor",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11204",
            "country_code": "US",
            "telephone_number": "505-715-9616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUJAN-GANTZ",
        "first_name": "AUDREY",
        "middle_name": "MAY",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "2677",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-22-58035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.