Connie Glenn, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

100516 Issued in CA

Practice address

721 N Vulcan Ave Ste 106-108
Encinitas, CA 92024-2190

Phone

(760) 942-8663

NPI assigned

Jul 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Connie Glenn, LMFT, Individual and Family Therapy, Inc.

  • Marriage & Family Therapist
  • Solana Beach, CA
  • NPI 1477265742
  NPD Authorized official

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1043732209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15010 AVENIDA MONTUOSA APT A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921291459",
            "telephone_number": "858-525-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 N VULCAN AVE STE 106-108",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242190",
            "telephone_number": "760-942-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "CONNIE",
        "name_prefix": "Ms.",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonia Giron, DDS
• Tecia Giusta
• Julie Glazer, O.T.
• Glenmar Psychological Services PC
• Glenn G. Soppe MD PC
• Jamieson Scott Glenn, M.D.
• Globalstem Cell Health, Inc.
• Susan Mariscal Glockner, M.D.
• Nirosha Gnanassegarane
• Stacy Albinder Godes, DDS

• Marriage & Family Therapist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.