Provider Demographics
NPI:1659692788
Name:ARMIJO-GLENN, ANAMARIA (LMSW)
Entity Type:Individual
Prefix:
First Name:ANAMARIA
Middle Name:
Last Name:ARMIJO-GLENN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3724
Mailing Address - Country:US
Mailing Address - Phone:505-690-8826
Mailing Address - Fax:505-425-9223
Practice Address - Street 1:2528 RIDGE RUNNER RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4971
Practice Address - Country:US
Practice Address - Phone:505-425-2622
Practice Address - Fax:505-425-9223
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-089711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NME7436Medicaid