Provider Demographics
NPI:1336986306
Name:PERMAR, GLENN II (LPC)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:PERMAR
Suffix:II
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6863 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-2948
Mailing Address - Country:US
Mailing Address - Phone:954-253-1072
Mailing Address - Fax:
Practice Address - Street 1:6863 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-2948
Practice Address - Country:US
Practice Address - Phone:954-253-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0020871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health