Active NPI
Mary Martinez
- Behavior Analyst
- Las Cruces, NM
National Provider Identifier
1619415254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1250 Hillrise Cir
Las Cruces, NM 88011-4741 - Phone
- (720) 966-8200
- NPI assigned
- Feb 2, 2017
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
1250 Hillrise Cir
Las Cruces, NM 88011-4741
Mailing address
4620 Oliver Manor Dr
Parrish, FL 34219-7575
Phone (484) 408-4272
Other practice location 1
400 N Tampa St Ste 1550
Tampa, FL 33602-4737
Phone (484) 408-4272
Other names 1
- Mary Blackwell
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Junior Boom ABA LLC | Behavior Analyst | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Brooklyn, NY
- NPI 1861194490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1619415254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4620 OLIVER MANOR DR",
"city": "PARRISH",
"state": "FL",
"postal_code": "342197575",
"telephone_number": "484-408-4272"
},
{
"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": "720-966-8200"
}
],
"practiceLocations": [
{
"address_1": "400 N Tampa St Ste 1550",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336024737",
"country_code": "US",
"telephone_number": "484-408-4272",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-02",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "BLACKWELL",
"credential": "BCBA",
"code": "1",
"type": "Former Name"
}
]
}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 Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.