Active NPI
Gloria Martinez, LCPC, LPCC
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1164189288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CCMH0185541
- Practice address
- 12004 N Star TRL NW
Albuquerque, NM 87120-5042 - Phone
- (505) 450-7115
- NPI assigned
- Nov 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CP3322-R | NV | |
| Mental Health Counselor | 101YM0800X | CCMH0185541 | NM | Primary |
Addresses
Primary practice location
12004 N Star TRL NW
Albuquerque, NM 87120-5042
Mailing address
8023 Carpenter Creek Ave
Las Vegas, NV 89113-3685
Phone (505) 450-7115
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
| License | State | Type | Specialty |
|---|---|---|---|
| CCMH0185541 | NM | MD | Mental Health Counselor |
| CP3322-R | NV | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727481600000",
"number": "1164189288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8023 CARPENTER CREEK AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891133685",
"telephone_number": "505-450-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12004 N STAR TRL NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871205042",
"telephone_number": "505-450-7115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "GLORIA",
"credential": "LCPC, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-23",
"last_updated": "2024-09-28",
"certification_date": "2024-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CP3322-R",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "CCMH0185541",
"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 Sep 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.