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Mr. Glen Edward Tisdale, LPC
Mental Health Counselor in San Antonio, Texas
NPI 1851843437

Glen Edward Tisdale is a Mental Health Counselor based in San Antonio, TX and is specialized in Mental Health. Glen Edward Tisdale practices in San Antonio, TX and has the professional credentials of LPC. The NPI Number for Glen Edward Tisdale is 1851843437 and holds a License No. 73414 (Texas).

The current practice location address for Glen Edward Tisdale is 4235 Valleyfield St, San Antonio, TX and can be reached out via phone at 210-709-5848.

Location: 4235 Valleyfield St, San Antonio, TX, 78222-3714
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851843437
Provider Name
Glen Edward Tisdale
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
4235 Valleyfield St, San Antonio, TX, 78222-3714
Phone Number
210-709-5848
Fax Number
Provider Enumeration Date
10/28/2016
Last Update Date
10/19/2024
institution
Provider Business Practice Location Address Details
Address
4235 Valleyfield St
City
San Antonio
State
Texas
Zip
78222-3714
Phone Number
210-709-5848
Fax Number
person
Provider Business Mailing Address Details
Address
4235 Valleyfield St
City
San Antonio
State
Texas
Zip
78222-3714
Phone Number
210-709-5848
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
73414 (Texas)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
73414 (Texas)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
73414 (Texas)
Definition
Definition to come...
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