Individual
JAY HOWARD GLICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
301 W COLLEGE AVE, HMS SILVER CITY MENTAL HEALTH CENTER, SILVER CITY, NM 88061
(575) 313-8222
(575) 542-8367
Mailing address
530 DE MOSS ST, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8367
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0103521
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24785806
—
NM
Enumeration date
03/27/2007
Last updated
02/27/2008
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