# GLENN SHERWOOD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376906487
- **Authorized official:** MR. GLENN KEITH SHERWOOD LSCSW (OWNER)
- **Authorized official phone:** (316) 866-2882

## Contact information

- **Practice address:** 425 N BALTIMORE AVE STE 1, DERBY, KS 67037-1625
- **Practice address phone:** (316) 866-2882
- **Practice address fax:** (316) 866-2811
- **Mailing address:** 425 N BALTIMORE AVE STE 1, DERBY, KS 67037-1625
- **Mailing address phone:** (316) 866-2882
- **Mailing address fax:** (316) 866-2811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 003 | KS | — |
| 1041C0700X | Clinical Social Worker | 4118 | KS | Yes |

## Other

- **Enumeration date:** 04/05/2016
- **Last updated:** 04/18/2016