Healthcare Provider Details

I. General information

NPI: 1265399273
Provider Name (Legal Business Name): NATASHA STARR MARTINEZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BIA ROUTE 125
PINEHILL NM
87357
US

IV. Provider business mailing address

PO BOX 490
PINEHILL NM
87357-0490
US

V. Phone/Fax

Practice location:
  • Phone: 505-775-3353
  • Fax: 505-775-3630
Mailing address:
  • Phone: 505-775-3353
  • Fax: 505-775-3630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2022-0923
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: