Individual provider Active NPI

Marilyn Glassman, M.A.,MFT

  • Marriage & Family Therapist
  • Agoura Hills, CA
National Provider Identifier
1073812921
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC36529 Issued in CA
Practice address
30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314
Phone
(818) 292-4226
Fax
(818) 874-3066
NPI assigned
Mar 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC36529 CA Primary

Addresses

Primary practice location

30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314

Mailing address

30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314
Phone (818) 292-4226

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

State licenses

LicenseStateTypeSpecialty
MFC36529CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1073812921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 118",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014314",
            "telephone_number": "818-292-4226",
            "fax_number": "818-874-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 118",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014314",
            "telephone_number": "818-292-4226",
            "fax_number": "818-874-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSMAN",
        "first_name": "MARILYN",
        "name_prefix": "Ms.",
        "credential": "M.A.,MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC36529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.