Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glenn Eugene Ferguson, PHD

Individual provider Clinical Psychologist · NPI 1922391994

Glenn Eugene Ferguson, PHD is a Clinical Psychologist in Espanola, New Mexico. Qualified in 1997, 29 years ago. Practices with Meditelecare of Colorado LLC, a 3-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Colorado, New Jersey and New Mexico.

Years since qualifying
29
Licensed in
CO, NJ, NM
In the registry since
2011
Specialties on file
3
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

206 S Coronado Ave
Espanola, NM 87532-2792
Phone: (860) 788-6404
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1900 W Littleton Blvd, Littleton, CO 80120-2023 — (860) 788-6404

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY-2022-0061 (NM)
Clinical Psychologist Taxonomy 103TC0700X · Licence PSY.0004552 (CO)
Clinical Psychologist Taxonomy 103TC0700X · Licence 44SI00428700 (NJ)

Record details

NPI number1922391994
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedMay 24, 2011
Last updated in NPPESJuly 8, 2024
Certification dateJuly 8, 2024
Mailing addressPo Box 1595, Middletown, CT 06457-8095

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Meditelecare Of Colorado Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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