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NPI Code Detail

MEDICARE: MR. GLEN ALVIN MCCLINTOCK LCSW

MEDICARE:  MR. GLEN ALVIN MCCLINTOCK  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker18890CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467520668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GLEN ALVIN MCCLINTOCK LCSW
Provider Business Mailing Address
First Line : 1655 MISSION ST UNIT 1031
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94103-6404
Country : US
Telephone Number : 415-954-2022
Fax Number :
Provider Business Practice Location Address
First Line : 215 NE CERRITOS DR
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92262-6530
Country : US
Telephone Number : 415-954-2022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 04/17/2024

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Directions to “ MR. GLEN ALVIN MCCLINTOCK LCSW” Practice Location

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