Individual provider Active NPI

Ashley Martin-Cuellar, LMFT

  • Marriage & Family Therapist
  • Albuquerque, NM
National Provider Identifier
1366766339
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
CMF0159091 Issued in NM
Practice address
4273 Montgomery Blvd NE Ste K220
Albuquerque, NM 87109-6748
Phone
(505) 554-1283
Fax
(505) 207-6167
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X CMF0159091 NM Primary

Addresses

Primary practice location

4273 Montgomery Blvd NE Ste K220
Albuquerque, NM 87109-6748

Mailing address

4273 Montgomery Blvd NE Ste K220
Albuquerque, NM 87109-6748
Phone (505) 554-1283

Other practice location 1

4253 Montgomery Blvd NE Ste G130
Albuquerque, NM 87109-1106
Phone (505) 554-1283

Other identifiers 3

IdentifierTypeStateIssuer
9678361MedicaidNM
1366766339MedicaidNM
34183329MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131003161 NM Practitioner - Marriage and Family Therapist 2466805916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grace Therapy Services LLCGroup PAC ID 8820441371, 5 clinicians

Practice addresses (Care Compare)

4253 Montgomery Blvd NE
Suite G130
Albuquerque, NM 87109-1106
Phone (505) 554-1283

4273 Montgomery Blvd NE
Suite K220
Albuquerque, NM 87109-6748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CMF0159091NMMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Therapy Services, LLC Marriage & Family Therapist CurrentSince Nov 2, 2018 Accepting new patients

Locations

4253 Montgomery Blvd NE
Ste G130
Albuquerque, NM 87109
Phone (505) 554-1283

4273 Montgomery Blvd NE
Ste K220
Albuquerque, NM 87109
Phone (505) 278-0042

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1366766339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 MONTGOMERY BLVD NE STE K220",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096748",
            "telephone_number": "505-554-1283",
            "fax_number": "505-207-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4273 MONTGOMERY BLVD NE STE K220",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096748",
            "telephone_number": "505-554-1283",
            "fax_number": "505-207-6167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4253 Montgomery Blvd NE Ste G130",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871091106",
            "country_code": "US",
            "telephone_number": "505-554-1283",
            "fax_number": "505-207-6167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN-CUELLAR",
        "first_name": "ASHLEY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "CMF0159091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9678361",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366766339",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34183329",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.