Individual provider Active NPI

Maegan Glass, MA, LMHCA, NCC

  • Mental Health Counselor
  • Crown Point, IN
National Provider Identifier
1043817430
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
88000999A Issued in IN
Practice address
1308 N Main St
Crown Point, IN 46307-2719
Phone
(219) 301-0206
NPI assigned
Oct 8, 2020
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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 88000999A IN Primary

Addresses

Primary practice location

1308 N Main St
Crown Point, IN 46307-2719

Mailing address

2511 Fairveiw Ave
Lake Station, IN 46405
Phone (219) 301-0206

Other names 1

  • Mae Glass Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221003718 IN Practitioner - Mental Health Counselor 7517317191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter-Starke Services IncGroup PAC ID 1951293554, 44 clinicians

Practice addresses (Care Compare)

601 Wall St
Valparaiso, IN 46383-2512
Phone (574) 772-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
88000999AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Porter-Starke Services Inc. CurrentSince Jan 1, 2024 Accepting new patients
Porter-Starke Services Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

3229 Broadway
Ste 104
Gary, IN 46409
Phone (219) 487-5800

3229 Broadway
Ste 115
Gary, IN 46409
Phone (219) 806-3000

704 S State Road 2
Hebron, IN 46341
Phone (219) 806-3011

3176 Lancer St
Ste B
Portage, IN 46368
Phone (219) 806-3000

3176 Lancer St
Portage, IN 46368
Phone (219) 762-7318

601 Wall St
Valparaiso, IN 46383
Phone (219) 806-3011

2507 Cumberland Dr
Valparaiso, IN 46383
Phone (219) 476-4676

601 Wall St
Ste 201
Valparaiso, IN 46383

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1043817430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 FAIRVEIW AVE",
            "city": "LAKE STATION",
            "state": "IN",
            "postal_code": "46405",
            "telephone_number": "219-301-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 N MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072719",
            "telephone_number": "219-301-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "MAEGAN",
        "credential": "MA, LMHCA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88000999A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAE",
            "last_name": "GLASS",
            "credential": "MA, LMHCA, NCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.