Individual
MR. GLENN DOUGLAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPCC, LADC
Contact information
Practice address
1313 PENN AVE N, MINNEAPOLIS, MN 55411-3047
(612) 543-3742
(612) 302-4872
Mailing address
1313 PENN AVE N, MINNEAPOLIS, MN 55411-3047
(763) 746-6553
(612) 302-4872
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
41-1303326
MN
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/27/2010
Last updated
01/03/2020
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