Joni Renee Glackin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

95153 Issued in CA

Practice address

473 East Carnegie Drive Suite 200
San Bernardino, CA 92415-0001

Phone

(909) 970-4414

NPI assigned

Feb 2, 2022

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

Other names 1

• Joni Renee Dominguez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1053064782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 EAST CARNEGIE DRIVE SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150001",
            "telephone_number": "909-970-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 EAST CARNEGIE DRIVE SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150001",
            "telephone_number": "909-970-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLACKIN",
        "first_name": "JONI",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "95153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONI",
            "last_name": "DOMINGUEZ",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenda Ruby Giron, M.S.
• Kiarra Gist
• Marcus Daerious Gitchuway
• Horatius Gittens, MFTI
• Gustavia Givens Jr.
• Rosemary Glaven
• Evangeline Riley Glazier
• Himie Glomah
• Glucosamigos PC
• Philip Glukhovsky, D.C.

• Clinical Social Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.

Verify at the official NPI Registry.