Individual provider Active NPI

Charles Daniel Marquez, PSY.D.

  • Clinical Neuropsychologist
  • Albuquerque, NM
National Provider Identifier
1629607890
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
38070 Issued in TX
Practice address
1209 Mountain Road PL NE Ste R
Albuquerque, NM 87110-7845
Phone
(505) 407-5852
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 38070 TX Primary

Addresses

Primary practice location

1209 Mountain Road PL NE Ste R
Albuquerque, NM 87110-7845

Mailing address

PO Box 1134
Aztec, NM 87410-1134
Phone (505) 407-5852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240223003718 TX Practitioner - Clinical Psychologist 9830534387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Midwestern University College of Dental Medicine, Glendale, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Neuropsychology and Counseling Center LLCGroup PAC ID 5395070213, 2 clinicians

Practice addresses (Care Compare)

4101 McEwen Rd
Suite 318
Dallas, TX 75244-5257
Phone (469) 975-2411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38070TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Neuropsychology & Counseling Center, LLC Clinical Neuropsychologist CurrentSince Dec 16, 2023 Accepting new patients
Pate Rehabilitation Endeavors, LLC PastSince Apr 1, 2020 Accepting new patients

Locations

4101 McEwen Rd
Ste 318
Dallas, TX 75244
Phone (469) 975-2411

2301 Marsh Ln
#200
Plano, TX 75093
Phone (972) 695-6479

Organizations & group practices 2

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": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1629607890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1134",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874101134",
            "telephone_number": "505-407-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 MOUNTAIN ROAD PL NE STE R",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107845",
            "telephone_number": "505-407-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "CHARLES",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "38070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.