Individual provider Active NPI

Epimenia Marcella Martinez

  • Mental Health Counselor
  • Las Vegas, NM
National Provider Identifier
1700614831
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CTB-2024-0480 Issued in NM
Practice address
2528 Ridge Runner Rd
Las Vegas, NM 87701-4971
Phone
(505) 425-2622
Fax
(505) 425-9223
NPI assigned
Jul 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CTB-2024-0480 NM Primary

Addresses

Primary practice location

2528 Ridge Runner Rd
Las Vegas, NM 87701-4971

Mailing address

2528 Ridge Runner Rd
Las Vegas, NM 87701-4971
Phone (505) 425-2622

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

LicenseStateTypeSpecialty
CTB-2024-0480NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Counseling, Inc CurrentSince Jul 28, 2024 Accepting new patients
Carino Family Services Inc PastSince Jul 28, 2024 Accepting new patients

Locations

2528 Ridge Runner Rd
Las Vegas, NM 87701
Phone (505) 425-2622

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": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1700614831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2528 RIDGE RUNNER RD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014971",
            "telephone_number": "505-425-2622",
            "fax_number": "505-425-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2528 RIDGE RUNNER RD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014971",
            "telephone_number": "505-425-2622",
            "fax_number": "505-425-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "EPIMENIA",
        "middle_name": "MARCELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2024-0480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.