Active NPI
Jenna Marie Glick
- Behavior Technician
- Dunedin, FL
National Provider Identifier
1013635309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1022 Main St Ste J
Dunedin, FL 34698-5237 - Phone
- (727) 643-7695
- Fax
- (727) 643-7695
- NPI assigned
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1022 Main St Ste J
Dunedin, FL 34698-5237
Mailing address
1022 Main St Ste J
Dunedin, FL 34698-5237
Phone (727) 643-7695
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | stepbeyonddevelopment.com | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sagarian Enterprises, LLC | Single Specialty | Current | Accepting new patients |
Locations
1022 Main St
Ste J
Dunedin, FL 34698
Phone (727) 643-7695
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1013635309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1022 MAIN ST STE J",
"city": "DUNEDIN",
"state": "FL",
"postal_code": "346985237",
"telephone_number": "727-643-7695",
"fax_number": "727-643-7695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1022 MAIN ST STE J",
"city": "DUNEDIN",
"state": "FL",
"postal_code": "346985237",
"telephone_number": "727-643-7695",
"fax_number": "727-643-7695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLICK",
"first_name": "JENNA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-22",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "stepbeyonddevelopment.com",
"affiliation": "N",
"endpointDescription": "Office Website",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Office Website",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Office Website",
"address_1": "1022 Main St Ste J",
"city": "Dunedin",
"state": "FL",
"country_code": "US",
"postal_code": "346985237",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dunedin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.