Active NPI
Edward S Glassic, MA
- Mental Health Counselor
- Laureldale, PA
National Provider Identifier
1063672939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3314 Raymond St
Laureldale, PA 19605-2220 - Phone
- (610) 929-2138
- NPI assigned
- Jun 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
3314 Raymond St
Laureldale, PA 19605-2220
Mailing address
3314 Raymond St
Laureldale, PA 19605-2220
Phone (610) 929-2138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245801600000",
"number": "1063672939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3314 RAYMOND ST",
"city": "LAURELDALE",
"state": "PA",
"postal_code": "196052220",
"telephone_number": "610-929-2138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3314 RAYMOND ST",
"city": "LAURELDALE",
"state": "PA",
"postal_code": "196052220",
"telephone_number": "610-929-2138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSIC",
"first_name": "EDWARD",
"middle_name": "S",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-13",
"last_updated": "2009-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Laureldale, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.