Stephanie Ann Glacking, LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC.162433 Issued in OH

Practice address

5108 Sandy LN
Fairfield, OH 45014-2738

Phone

(513) 834-7063

NPI assigned

Aug 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Hayes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Brightview, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1659769446
  NPD (past)

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1033766241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "telephone_number": "513-834-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 SANDY LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142738",
            "telephone_number": "513-834-7063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 East Crescentville Drive",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45246",
            "country_code": "US",
            "telephone_number": "513-671-7117 x25",
            "fax_number": "513-671-7110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLACKING",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HAYES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ross Michael Gille, DDS
• Lee Gillespie
• Daniel J Giltner, MD
• Ankur Girdhar, M.D.
• Jeremy Robert Girmann, D.O.
• Rachel Lynn Glasmeier, MOT
• Michelle Glass, OD
• Sharad Goel, M.D.
• Ashli Golic, AT, ATC
• Joseph Eubanks Goode

• Addiction (Substance Use Disorder) Counselor in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.