Life Re-Created LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LIFE RE-CREATED LLC

Practice address

3939 San Pedro Dr. NE
BLD C, Ste 8
Albuquerque, NM 87110

Phone

(505) 369-6756

Fax

(505) 393-5201

NPI assigned

Jun 21, 2019

Organization subpart

No

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

Authorized official

Name

Cathryn Ana Glenday, MPH MA LPCCNPI 1477006815

Title

Owner

Phone

(505) 369-6756

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cathryn Ana Glenday, MPH, MA, LPCC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1477006815
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1033770904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8946",
            "address_2": "C/O CATHRYN GLENDAY",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871988946",
            "telephone_number": "505-369-6756",
            "fax_number": "505-393-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 SAN PEDRO DR. NE",
            "address_2": "BLD C, STE 8",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-369-6756",
            "fax_number": "505-393-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RE-CREATED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-21",
        "last_updated": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "GLENDAY",
        "authorized_official_first_name": "CATHRYN",
        "authorized_official_middle_name": "ANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-369-6756",
        "authorized_official_credential": "MPH MA LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9673365",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://caglpcc.mytherabook.com/home/login",
            "affiliation": "N",
            "endpointDescription": "secure communication between client and therapist",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "forms, treatment plans, email",
            "address_1": "3939 San Pedro Dr. Ne",
            "address_2": "Bld C, Ste 8",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "87110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.