Provider Demographics
NPI:1326289968
Name:BLEGEN, GLENDA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GLENDA
Middle Name:
Last Name:BLEGEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 W WINDROSE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-2806
Mailing Address - Country:US
Mailing Address - Phone:602-978-2128
Mailing Address - Fax:
Practice Address - Street 1:7585 E REDFIELD RD
Practice Address - Street 2:SUITE 211
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6936
Practice Address - Country:US
Practice Address - Phone:480-951-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0775101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health