Mary Elizabeth Glass, LMHC, CRCC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

CRC00005090 Issued in IL

Practice address

6820 Porto Fino Circle
Suite 1
Ft Myers, FL 33912-7133

Phone

(239) 225-1364

Fax

(239) 225-7337

NPI assigned

Aug 27, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1013265933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 PORTO FINO CIRCLE",
            "address_2": "SUITE 1",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339127133",
            "telephone_number": "239-225-1364",
            "fax_number": "239-225-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 PORTO FINO CIRCLE",
            "address_2": "SUITE 1",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339127133",
            "telephone_number": "239-225-1364",
            "fax_number": "239-225-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "LMHC, CRCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "FL",
            "license": "MH2377",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "CRC00005090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladiolus Homecare Services LLC
• Gladiolus Medical Center Corp.
• Gladiolus Surgery Center , LLC
• Traci Joy Glanz, DNP-FNP-C
• Amanda Rose Glass
• Matthew Howard Glass, LCSW
• Susan Kay Glass, LPN
• L. Diane Glasscock, LMHC
• Glasses RX, LLC
• Glasses RX, LLC

• Psychiatry Physician in Ft Myers, FL
• Providers in Ft Myers, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.