Healthcare Provider Details

I. General information

NPI: 1447932371
Provider Name (Legal Business Name): STEPHEN ANDREW GLASSNER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14328 W 115TH PL UNIT 102
OLATHE KS
66062-4682
US

IV. Provider business mailing address

1707 E CEDAR ST
OLATHE KS
66062-1892
US

V. Phone/Fax

Practice location:
  • Phone: 573-680-9989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13902
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: