Glen Brian Robinson, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302259 Issued in MN

Practice address

13100 Wayzata Blvd Ste 200
Minnetonka, MN 55305-1810

Phone

(952) 206-2040

Fax

(952) 206-2041

NPI assigned

Jan 23, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Community Resources for Education Alternative Treatments & Evaluation

  • Addiction (Substance Use Disorder) Counselor
  • Minneapolis, MN
  • NPI 1336212653
  NPD (past)
• Create Inc

  • Addiction (Substance Use Disorder) Counselor
  • Plymouth, MN
  • NPI 1730581646
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1306023262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13100 WAYZATA BLVD STE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051810",
            "telephone_number": "952-206-2040",
            "fax_number": "952-206-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 WAYZATA BLVD STE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051810",
            "telephone_number": "952-206-2040",
            "fax_number": "952-206-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "GLEN",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-23",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "302259",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alesha N Roach, M.D.
• Brian Donald Roach, M.D.
• Deanna M Roberson, CNP
• Debra Wood Roberts, PT
• Chandra M Robinson-James, FNP
• Haley Poteat Robinson, MD
• Meredith Lynn Robinson, LPCC
• Jordan Roby, D.C.
• Ashley Nicole Rocha
• Susan Rockers, RN

• Addiction (Substance Use Disorder) Counselor in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.