Provider Demographics
NPI:1265551345
Name:FLOWERS, GLENDA KENNETTA (LCPC, CCS)
Entity type:Individual
Prefix:MS
First Name:GLENDA
Middle Name:KENNETTA
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:LCPC, CCS
Other - Prefix:MRS
Other - First Name:GLENDA
Other - Middle Name:KENNETTA
Other - Last Name:RIVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCDC
Mailing Address - Street 1:38 HUXLEY CIR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1734
Mailing Address - Country:US
Mailing Address - Phone:410-515-4675
Mailing Address - Fax:
Practice Address - Street 1:38 HUXLEY CIR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1734
Practice Address - Country:US
Practice Address - Phone:410-515-4675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4159101YA0400X
MDLC2115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health