Glenda K Thomson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW30186 Issued in ID

Practice address

2235 E 25TH St
Suite 290
Idaho Falls, ID 83404-7519

Phone

(208) 552-0490

Fax

(208) 552-2518

NPI assigned

Apr 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Teris Health Services LLCGroup PAC ID 2163857392, 6 clinicians

Mountain Park Health CenterGroup PAC ID 8325949647, shared by 11 NPIs, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Teris Health Services LLC

  • Professional Counselor
  • Phoenix, AZ
  • NPI 1215422126
  Medicare reassignment Care Compare group NPD
• Teri'S Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1790374833
  NPD
• Psychological Service Associates

  • Clinical Psychologist
  • Idaho Falls, ID
  • NPI 1871672840
  NPD (past)
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1063738359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 E 25TH ST",
            "address_2": "SUITE 290",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047519",
            "telephone_number": "208-552-0490",
            "fax_number": "208-552-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E 25TH ST",
            "address_2": "SUITE 290",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047519",
            "telephone_number": "208-552-0490",
            "fax_number": "208-552-2518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14040 N Cave Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850226117",
            "country_code": "US",
            "telephone_number": "602-358-7073",
            "fax_number": "888-927-0409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "GLENDA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-21529",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW30186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806472900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rex D Thompson, DDS
• Rhonda Thompson, LCSW
• Terry L Thompson, RN NP-C
• Timothy James Thompson, LMSW
• Travis Thompson, D.C.
• James Thomson, M.D.
• Makaila Jane Thormahlen
• Amy Diana Thornley, ACNP-BC
• Rex Delane Thornley, LCSW
• Ronadee Marie Thornock, LMSW

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.