Provider Demographics
NPI:1477006815
Name:GLENDAY, CATHRYN ANA (MPH, MA, LPCC)
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:ANA
Last Name:GLENDAY
Suffix:
Gender:F
Credentials:MPH, MA, LPCC
Other - Prefix:
Other - First Name:MARIANNA
Other - Middle Name:CATHRYN
Other - Last Name:GLENDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, MA
Mailing Address - Street 1:PO BOX 8946
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87198-8946
Mailing Address - Country:US
Mailing Address - Phone:505-264-4082
Mailing Address - Fax:
Practice Address - Street 1:3939 SAN PEDRO DR NE BLDG C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-8900
Practice Address - Country:US
Practice Address - Phone:505-369-6756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0203791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM96733365Medicaid