Active NPI
Melissa Ivanna Martinez
- Counselor
- Boulder, CO
National Provider Identifier
1215429626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- NLC.0108511
- Practice address
- 703 Walnut St
Boulder, CO 80302-5032 - Phone
- (830) 422-1335
- NPI assigned
- May 31, 2018
- Last updated
- Aug 11, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NLC.0108511 | CO | Primary |
Addresses
Primary practice location
703 Walnut St
Boulder, CO 80302-5032
Mailing address
703 Walnut St
Boulder, CO 80302-5032
Other practice location 1
8791 Wolff Ct Ste 200
Westminster, CO 80031-3693
Phone (970) 299-9183
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 |
|---|---|---|---|
| NLC.0108511 | CO | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Myth Counseling | Current | Accepting new patients |
Locations
8791 Wolff Ct
Ste 200
Westminster, CO 80031
Phone (303) 532-5646
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Westminster, CO
- NPI 1295500049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754870400000",
"number": "1215429626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 WALNUT ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803025032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 WALNUT ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803025032",
"telephone_number": "830-422-1335"
}
],
"practiceLocations": [
{
"address_1": "8791 Wolff Ct Ste 200",
"address_purpose": "LOCATION",
"city": "Westminster",
"state": "CO",
"postal_code": "800313693",
"country_code": "US",
"telephone_number": "970-299-9183",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ",
"first_name": "MELISSA",
"middle_name": "IVANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-31",
"last_updated": "2025-08-11",
"certification_date": "2025-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "NLC.0108511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.