Individual provider Active NPI

Glen Allen Mears, LCSW

  • Clinical Social Worker
  • Roswell, NM
National Provider Identifier
1295734929
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2022-1105 Issued in NM
Practice address
208 N Kansas Ave
Mearsglen@Gail.Com
Roswell, NM 88201-0117
Phone
(719) 845-7956
Fax
(719) 845-7956
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09924447 CO
Clinical Social Worker 1041C0700X SWB-2022-1105 NM Primary

Addresses

Primary practice location

208 N Kansas Ave
Mearsglen@Gail.Com
Roswell, NM 88201-0117

Mailing address

208 N Kansas Ave
Mearsglen@Gmail.Com
Roswell, NM 88201-0117
Phone (719) 845-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091019000487 TX Practitioner - Clinical Social Worker 9335119825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS,PHS,Naihs, Gallup Indian Medical CenterGroup PAC ID 3173436409, 179 clinicians

Practice addresses (Care Compare)

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09924447COMDClinical Social Worker
SWB-2022-1105NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Aug 8, 2025 Accepting new patients
Las Animas-Huerfano Counties District Health Department PastSince Jul 10, 2025 Accepting new patients
Deer Oaks Mental Health Associates PC Past Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1295734929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N KANSAS AVE",
            "address_2": "MEARSGLEN@GMAIL.COM",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882010117",
            "telephone_number": "719-845-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N KANSAS AVE",
            "address_2": "MEARSGLEN@GAIL.COM",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882010117",
            "telephone_number": "719-845-7956",
            "fax_number": "719-845-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEARS",
        "first_name": "GLEN",
        "middle_name": "ALLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924447",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.