Organization
FRESH START COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN DOUGLAS SMITH MS, LPCC, LADC (COUNSELOR)
(763) 746-6553
Entity
Organization
Contact information
Practice address
3808 83RD AVE N, BROOKLYN PARK, MN 55443-2753
(763) 746-6553
Mailing address
3808 83RD AVE N, BROOKLYN PARK, MN 55443-2753
(763) 746-6553
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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