Provider Demographics
NPI:1598101230
Name:GLENN, BARBARA C (LCPC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:C
Last Name:GLENN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 LOG CANOE CIR
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-2127
Mailing Address - Country:US
Mailing Address - Phone:410-604-0226
Mailing Address - Fax:877-643-0126
Practice Address - Street 1:155 LOG CANOE CIR
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2127
Practice Address - Country:US
Practice Address - Phone:410-604-0226
Practice Address - Fax:877-643-0126
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP5046101YM0800X
MDLC6123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD520202701Medicaid
MD520202703Medicaid
MDR968OtherCAREFIRST
MD609550005Medicaid
MD517251OtherOPTUM
MD7840093OtherAETNA
MD259147-000OtherMAGELLAN BEHAVIORAL HEALTH
MD346646OtherMHN
MD609550001Medicaid
MD609550002Medicaid
MD522156095OtherAPS