NPIMap

Individual provider Active NPI

Judith Glixon, LMHC

  • Mental Health Counselor
  • Concord, MA
National Provider Identifier
1023327954
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5118 Issued in MA
Practice address
111 Old Road to 9 Acre Cor
Concord, MA 01742-4141
Phone
(978) 369-1113
Fax
(978) 369-0908
NPI assigned
Sep 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5118 MA Primary

Addresses

Primary practice location

111 Old Road to 9 Acre Cor
Concord, MA 01742-4141

Mailing address

111 Old Rd. to 9 Acre Corner
The Eliot Center
Concord, MA 01742
Phone (978) 369-1113

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

State licenses

LicenseStateTypeSpecialty
5118MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services Past Accepting new patients
My Health101 PC Past Accepting new patients

Organizations & group practices 2

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": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1023327954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OLD RD. TO 9 ACRE CORNER",
            "address_2": "THE ELIOT CENTER",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-369-1113",
            "fax_number": "978-369-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424141",
            "telephone_number": "978-369-1113",
            "fax_number": "978-369-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIXON",
        "first_name": "JUDITH",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "5118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.