Organization
GLENN SHERWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN KEITH SHERWOOD LSCSW (OWNER)
(316) 866-2882
Entity
Organization
Contact information
Practice address
425 N BALTIMORE AVE STE 1, DERBY, KS 67037-1625
(316) 866-2882
(316) 866-2811
Mailing address
425 N BALTIMORE AVE STE 1, DERBY, KS 67037-1625
(316) 866-2882
(316) 866-2811
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
003
KS
1041C0700X
Clinical Social Worker
Primary
4118
KS
Other
Enumeration date
04/05/2016
Last updated
04/18/2016
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