# GLENN BLUMENSON LCSW PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Five Valleys Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942864491
- **Authorized official:** GLENN BLUMENSON LCSW (CEO)
- **Authorized official phone:** (406) 823-0108

## Contact information

- **Practice address:** 111 N HIGGINS AVE STE 409, MISSOULA, MT 59802-4433
- **Practice address phone:** (406) 823-0108
- **Mailing address:** 603 S 3RD ST W APT 2, MISSOULA, MT 59801-2538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 04/30/2019
- **Last updated:** 04/30/2019