Angela Dawn Glick, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

776 Issued in WV

Practice address

306 Main St
Logan, WV 25601-3906

Phone

(304) 752-7707

Fax

(304) 752-0772

NPI assigned

Jan 5, 2007

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Angel Dawn Glick Other name

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boone Memorial Hospital IncGroup PAC ID 3375433352, shared by 8 NPIs, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/boonemh-81155461

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Boone Memorial Hospital, Inc

  dba BMH Family Medical Center

  • Rural Health Clinic/Center
  • Madison, WV
  • NPI 1578513032

  W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boone Memorial Hospital, Inc

  dba Boone Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Madison, WV
  • NPI 1285686725
  Medicare reassignment NPD
• Boone Memorial Hospital, Inc

  dba Boone Memorial Hospital

  • Critical Access Hospital
  • Madison, WV
  • NPI 1639135221
  Medicare reassignment NPD
• Boone Memorial Hospital, Inc

  dba BMH Medical Clinic

  • Rural Health Clinic/Center
  • Madison, WV
  • NPI 1801039565
  NPD
• Boone Memorial Hospital, Inc

  dba BMH Danville Clinic

  • Rural Health Clinic/Center
  • Danville, WV
  • NPI 1124617535
  NPD (past)
• Boone Memorial Hospital, Inc

  dba BMH Brighter Futures

  • Community/Behavioral Health Agency
  • Madison, WV
  • NPI 1184361347
  NPD (past)
• Boone Memorial Hospital, Inc

  dba BMH Family Medical Center

  • Rural Health Clinic/Center
  • Madison, WV
  • NPI 1578513032
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1144377540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MADISON AVE",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251301699",
            "telephone_number": "304-369-1230",
            "fax_number": "304-369-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013906",
            "telephone_number": "304-752-7707",
            "fax_number": "304-752-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS SHIELD PROVIDER",
            "identifier": "001715137",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9202037000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "GLICK",
            "middle_name": "DAWN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Linda M George, MA CCC-S
• Ghazala Quddus, M.D., Inc.
• Diane Faye Gibson, BA, LSW
• Maranda Gilkerson
• Glenmark Limited Liability Company I (Logan Center)
• Fernando Luis Gonzalez-Ramos, MD
• Genevieve Gordon
• Sabrina Lynne Grace, MS CCC-S
• Stephanie Renee Griffith
• Karan D Grimes, FNP

• Clinical Psychologist in Logan, WV
• Providers in Logan, WV by specialty
• Clinical Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.