Provider Demographics
NPI:1811129133
Name:GLENN, STEPHEN ANDREW (BA, RC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:ANDREW
Last Name:GLENN
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Gender:M
Credentials:BA, RC
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Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:8705 166TH AVE NE
Practice Address - Street 2:STILLWATER HOUSE
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3749
Practice Address - Country:US
Practice Address - Phone:425-653-5080
Practice Address - Fax:425-653-5081
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WARC60083674101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional