Shaylee Martinez, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

X12209 Issued in NM

Practice address

4001 Office Court Dr Ste 102
Santa Fe, NM 87507-4903

Phone

(505) 983-8225

Fax

(505) 930-5427

NPI assigned

Feb 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Earth Spirit Awakenings LLC

  dba Mesa Vista Wellness

  • Community/Behavioral Health Agency
  • Santa Fe, NM
  • NPI 1447490800
  NPD

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1568116218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 807",
            "city": "CHIMAYO",
            "state": "NM",
            "postal_code": "875220807",
            "telephone_number": "505-484-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 OFFICE COURT DR STE 102",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074903",
            "telephone_number": "505-983-8225",
            "fax_number": "505-930-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "SHAYLEE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "X12209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15510755",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@mesavistawellness.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Earth Spirit Awakenings LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4001 Office Court Dr Ste 102",
            "city": "Santa Fe",
            "state": "NM",
            "country_code": "US",
            "postal_code": "875074903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Martinez
• Rebecca Martinez
• Renee Martinez
• Rey Martinez
• Ryan Martinez, LSAA
• Stephanie Martinez
• Teresa Mia Martinez, M.A.
• Vilma V Martinez
• Yolanda Martinez
• Yzetta Elaine Martinez, LPCC

• Clinical Social Worker in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.