Glenn Douglas Smith, MS, LPCC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1313 Penn Ave N
Minneapolis, MN 55411-3047

Phone

(612) 543-3742

Fax

(612) 302-4872

NPI assigned

Jul 27, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Earl Lee Smith Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Fresh Start Counseling

  • Addiction (Substance Use Disorder) Counselor
  • Brooklyn Park, MN
  • NPI 1538777131
  NPD Authorized official

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1447564869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113047",
            "telephone_number": "763-746-6553",
            "fax_number": "612-302-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113047",
            "telephone_number": "612-543-3742",
            "fax_number": "612-302-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GLENN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MS, LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "41-1303326",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glenn.smith@hennepin.us",
            "affiliation": "N",
            "address_1": "1313 Penn Ave N",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554113047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EARL",
            "last_name": "SMITH",
            "middle_name": "LEE",
            "credential": "MS,LPCC, LADC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Eric Adrian Smith, D.M.D.
• Eric Andrew Smith, PA
• Eric J Smith, APRN, CRNA
• Erin Elizabeth Smith
• Evan Smith
• Hannah Smith
• Heather Smith, MSW,LGSW
• Henry T Smith, MD
• Jack Smith
• Jan Lynn Smith, LICSW

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.