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Individual
GLEN WILLIAM CROSS
Active
Individual
GLEN WILLIAM CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00104
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
01
—
30009-0
BLUE CROSS
RI
01
—
407903
BLUE CHIP
RI
01
—
62-40330
UNITED BEHAVIORAL HEALTH
RI
05
—
GC27077
—
RI
Enumeration date
06/02/2006
Last updated
09/16/2021
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