Individual provider Active NPI

Mary Von Witzleben, PHD, BCBA

  • Psychologist
  • Las Cruces, NM
National Provider Identifier
1205155603
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
1250 Hillrise Cir
Las Cruces, NM 88011-4741
Phone
(575) 288-1881
Fax
(575) 288-1889
NPI assigned
May 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 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 1095675 FL
Psychologist 103T00000X Primary

Addresses

Primary practice location

1250 Hillrise Cir
Las Cruces, NM 88011-4741

Mailing address

1250 Hillrise Cir
Las Cruces, NM 88011-4741
Phone (575) 288-1881

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1095675FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1205155603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HILLRISE CIR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114741",
            "telephone_number": "575-288-1881",
            "fax_number": "575-288-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HILLRISE CIR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114741",
            "telephone_number": "575-288-1881",
            "fax_number": "575-288-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON WITZLEBEN",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PHD, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1095675",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.