Individual
GLEN EUGENE STOVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.W.
Contact information
Practice address
645 E IRON AVE, SUITE D, SALINA, KS 67401-2697
(785) 827-2700
(785) 309-0184
Mailing address
645 E IRON AVE, SUITE D, SALINA, KS 67401-2697
(785) 827-2700
(785) 309-0184
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSCSW 1078
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011556
BLUE CROSS BLUE SHIELD
KS
05
—
100097970A
—
KS
01
—
32748
CIGNA
KS
01
—
91946
MANAGED HEALTH NETWORK
KS
Enumeration date
06/14/2006
Last updated
09/29/2010
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