Provider Demographics
NPI:1215035761
Name:KAPLAN, GLENN M (PHD)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:M
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15600 E CHERRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CO
Mailing Address - Zip Code:80118-5003
Mailing Address - Country:US
Mailing Address - Phone:303-434-6023
Mailing Address - Fax:303-663-1939
Practice Address - Street 1:15600 E CHERRY CREEK RD
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CO
Practice Address - Zip Code:80118-5003
Practice Address - Country:US
Practice Address - Phone:303-434-6023
Practice Address - Fax:303-663-1939
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO841291614103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily