Individual provider Active NPI

Glenn Warren Frost, LCSW-R, ACSW

  • Mental Health Counselor
  • Tonawanda, NY
National Provider Identifier
1053491555
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R049406-1 Issued in NY
Practice address
884 Brighton Rd
Tonawanda, NY 14150-8169
Phone
(716) 836-9460
Fax
(716) 836-9462
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R049406-1 NY Primary

Addresses

Primary practice location

884 Brighton Rd
Tonawanda, NY 14150-8169

Mailing address

254 Peppertree Dr
Amherst, NY 14228-2949
Phone (716) 564-0296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080122000054 NY Practitioner - Clinical Social Worker 5294816856 Practice locations: Amherst, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3980 Sheridan Dr
Suite 406
Amherst, NY 14226-1727
Phone (716) 417-9998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R049406-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053491555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 PEPPERTREE DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282949",
            "telephone_number": "716-564-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508169",
            "telephone_number": "716-836-9460",
            "fax_number": "716-836-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "GLENN",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "credential": "LCSW-R, ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R049406-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.