Organization
GLIDDEN COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROM GLIDDEN LCPC (OWNER)
(208) 597-0994
Entity
Organization
Contact information
Practice address
1224 WASHINGTON AVE STE 205, SANDPOINT, ID 83864-5055
(208) 597-0994
(208) 701-6277
Mailing address
1106 POPLAR ST., SANDPOINT, ID 83864
(208) 597-0994
(208) 701-6277
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
104100000X
Social Worker
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807651800
—
ID
Enumeration date
09/17/2019
Last updated
05/20/2020
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