Provider Demographics
NPI:1760787899
Name:GLOVER, CHRISTINE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 CAMINO DON MIGUEL
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5947
Mailing Address - Country:US
Mailing Address - Phone:505-820-2087
Mailing Address - Fax:
Practice Address - Street 1:2960 RODEO PARK DRIVE WEST
Practice Address - Street 2:SANTA FE COMMUNITY GUIDANCE CENTER
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6351
Practice Address - Country:US
Practice Address - Phone:505-986-9633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0137201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health