Healthcare Provider Details

I. General information

NPI: 1629935051
Provider Name (Legal Business Name): NEW MEXICO PSYCHOLOGICAL AND BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 ALAMEDA BLVD NE STE B1
ALBUQUERQUE NM
87113-1569
US

IV. Provider business mailing address

315 ALAMEDA BLVD NE STE B1
ALBUQUERQUE NM
87113-1569
US

V. Phone/Fax

Practice location:
  • Phone: 505-433-7348
  • Fax: 505-433-7348
Mailing address:
  • Phone: 505-433-7348
  • Fax: 505-433-7348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN MARTINS
Title or Position: OWNER
Credential: PHD
Phone: 505-433-7348