Jay Howard Glickman, LPCC
Individual provider Active NPI Counselor · Silver City, NM
NPI 1184742009 · NPPES record last updated Feb 27, 2008
Key facts
- NPI
- 1184742009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 0103521 (NM)
- Practice address
- 301 W College Ave
HMS Silver City Mental Health Center
Silver City, NM 88061 - Phone
- (575) 313-8222
- Fax
- (575) 542-8367
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0103521 | NM | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0103521 | NM | Yes |
Addresses
Primary practice location
301 W College Ave
HMS Silver City Mental Health Center
Silver City, NM 88061
Mailing address
530 De Moss St
Lordsburg, NM 88045-2618
Phone (575) 542-8384
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24785806 | Medicaid | NM |
Other providers in Silver City, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.