Individual provider Active NPI

Attaliah Dellainer Glover, LCAS-A , J.D

  • Addiction (Substance Use Disorder) Counselor
  • Gastonia, NC
National Provider Identifier
1164281036
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
29703 Issued in NC
Practice address
175 W Franklin Blvd
Gastonia, NC 28052-4145
Phone
(718) 593-1607
NPI assigned
Mar 14, 2024
Last updated
May 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 29703 NC Primary
Mental Health Counselor 101YM0800X A19912 NC

Addresses

Primary practice location

175 W Franklin Blvd
Gastonia, NC 28052-4145

Mailing address

632 Sawyers Mill Rd Apt 302
Charlotte, NC 28262-1838
Phone (718) 593-1607

Other practice location 1

429 Billingsley Rd
Charlotte, NC 28211-1007
Phone (704) 445-6900

Other practice location 2

100 Billingsley Rd
Charlotte, NC 28211-1002
Phone (704) 376-7447

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
Juris Doctor

State licenses

LicenseStateTypeSpecialty
29703NCMDAddiction (Substance Use Disorder) Counselor
A19912NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1164281036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 SAWYERS MILL RD APT 302",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621838",
            "telephone_number": "718-593-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W FRANKLIN BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524145",
            "telephone_number": "718-593-1607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 Billingsley Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111007",
            "country_code": "US",
            "telephone_number": "704-445-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Billingsley Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111002",
            "country_code": "US",
            "telephone_number": "704-376-7447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "ATTALIAH",
        "middle_name": "DELLAINER",
        "credential": "LCAS-A , J.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "29703",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A19912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.