Individual provider Active NPI

Erin Glackin, PHD

  • Clinical Child & Adolescent Psychologist
  • Denver, CO
National Provider Identifier
1124639117
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY.0005959 Issued in CO
Practice address
3401 Eudora St
Denver, CO 80207-2500
Phone
(303) 300-6152
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY.0005959 CO Primary

Addresses

Primary practice location

3401 Eudora St
Denver, CO 80207-2500

Mailing address

3401 Eudora St
Denver, CO 80207-2500
Phone (303) 300-6152

Other practice location 1

4353 E Colfax Ave
Denver, CO 80220-1115
Phone (844) 493-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20221031001198 CO Practitioner - Clinical Psychologist 3072980325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of Denver Current Accepting new patients
Mental Health Center of Denver CurrentSince Oct 7, 2022 Accepting new patients

Locations

4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6509

3401 Eudora St
Denver, CO 80207
Phone (303) 300-6266

4353 E Colfax Ave
Denver, CO 80220
Phone (303) 504-1200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1124639117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 EUDORA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072500",
            "telephone_number": "303-300-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 EUDORA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072500",
            "telephone_number": "303-300-6152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4353 E Colfax Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802201115",
            "country_code": "US",
            "telephone_number": "844-493-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLACKIN",
        "first_name": "ERIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "PSY.0005959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.