Healthcare Provider Details

I. General information

NPI: 1073188124
Provider Name (Legal Business Name): LEONARDO MARTINEZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 W BROADWAY ST
HOBBS NM
88240-5529
US

IV. Provider business mailing address

PO BOX 2671
ANTHONY NM
88021-2671
US

V. Phone/Fax

Practice location:
  • Phone: 575-393-3168
  • Fax:
Mailing address:
  • Phone: 575-882-5100
  • Fax: 575-882-1151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-1253
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-11510
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: