| Kassondra Glenn Lcsw Llc | |
|
1331 Park Ave Sw Albuquerque NM 87102-4565 | |
| (917) 819-2883 | |
| Not Available |
| Full Name | Kassondra Glenn Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1331 Park Ave Sw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Kassondra Glenn (OWNER) |
| Authorized Official Contact | 9178192883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kassondra Glenn Lcsw Llc Po Box 11 Albuquerque NM 87103-0011 Ph: () - | Kassondra Glenn Lcsw Llc 1331 Park Ave Sw Albuquerque NM 87102-4565 Ph: (917) 819-2883 |
| NPI Number | 1093421414 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 06/02/2023 |
| Certification Date | 06/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093421414 | NPI | - | NPPES |
| 78180244 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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