Provider Demographics
NPI:1801343207
Name:HARPER, GLENN (CSAC, CADC II)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:HARPER
Suffix:
Gender:M
Credentials:CSAC, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 KUPULAU DR
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-9349
Mailing Address - Country:US
Mailing Address - Phone:831-325-8127
Mailing Address - Fax:
Practice Address - Street 1:711 KUPULAU DR
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-9349
Practice Address - Country:US
Practice Address - Phone:831-325-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)