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General NPI Number Information
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NPI Number | 1295734929
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Entity Type | Individual
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Provider Name | GLEN ALLEN MEARS LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 208 N KANSAS AVE MEARSGLEN@GAIL.COM
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City | ROSWELL
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State | NM
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Zip | 88201-0117
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Country | US
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Telephone | 719-845-7956
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Fax | 719-845-7956
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Provider Business Mailing Address
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Address Line | 208 N KANSAS AVE MEARSGLEN@GMAIL.COM
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City | ROSWELL
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State | NM
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Zip | 88201-0117
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Country | US
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Telephone | 719-845-7956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09924447
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SWB-2022-1105
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License Number State | NM
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