Provider Demographics
NPI:1174236210
Name:MOST, GLENN EVAN (PSYD)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:EVAN
Last Name:MOST
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9210 E BERRY AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3508
Mailing Address - Country:US
Mailing Address - Phone:720-644-7477
Mailing Address - Fax:
Practice Address - Street 1:9210 E BERRY AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3508
Practice Address - Country:US
Practice Address - Phone:720-644-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2460103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical