Individual
MR. CLINTON GLIDEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
757 ARMSTRONG AVE, KANSAS CITY, KS 66101-2701
(913) 233-3300
Mailing address
757 ARMSTRONG AVE, KANSAS CITY, KS 66101-2701
(913) 233-3300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6120
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
01
—
100098080C
SED WAIVER
KS
01
—
3620000
MEDICARE
KS
Enumeration date
12/17/2015
Last updated
12/17/2015
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