Provider Demographics
NPI:1891197257
Name:HERNANDEZ, GLENDA (LSCSW, LCSW)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LSCSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 MARTY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2561
Mailing Address - Country:US
Mailing Address - Phone:913-414-3579
Mailing Address - Fax:913-392-2880
Practice Address - Street 1:10550 MARTY ST STE 101
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2561
Practice Address - Country:US
Practice Address - Phone:913-414-3579
Practice Address - Fax:913-392-2880
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170142531041C0700X
KS49671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical