Provider Demographics
NPI:1982794004
Name:GLUCK, NORA (NORA GLUCK)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:GLUCK
Suffix:
Gender:F
Credentials:NORA GLUCK
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:GLUCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NORA GLUCK,LCSW,LMFT
Mailing Address - Street 1:600 AVENIDA VILLA HERMOSA UNIT 207
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87506-4536
Mailing Address - Country:US
Mailing Address - Phone:203-913-8912
Mailing Address - Fax:
Practice Address - Street 1:600 AVENIDA VILLA HERMOSA UNIT 207
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87506-4536
Practice Address - Country:US
Practice Address - Phone:203-913-8912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-117751041C0700X
CTLMFT 000301106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist