Glynnis Pellett Urban, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2292 Issued in NM

Practice address

1118 W Aztec Blvd
Aztec, NM 87410-1800

Phone

(505) 334-3695

Fax

(505) 599-4388

NPI assigned

Nov 7, 2006

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aztec Municipal Schools

  • Local Education Agency (LEA)
  • Aztec, NM
  • NPI 1649469271
  NPD
• Clovis Municipal Schools

  • Local Education Agency (LEA)
  • Clovis, NM
  • NPI 1174662316
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1093884520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 W AZTEC BLVD",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874101800",
            "telephone_number": "505-419-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 W AZTEC BLVD",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874101800",
            "telephone_number": "505-334-3695",
            "fax_number": "505-599-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAN",
        "first_name": "GLYNNIS",
        "middle_name": "PELLETT",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "2292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23930772",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Karen L Vogel, M.A.CCC-SP
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• Merrilee Williams, SLP
• Kalee Wilmer, MSW

• Mental Health Counselor in Aztec, NM
• Providers in Aztec, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.