Individual provider Active NPI

Glen Pittman, LMSW

  • Social Worker
  • Wilmington, DE
National Provider Identifier
1205179769
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
Q3-001083 Issued in DE
Practice address
2300 Pennsylvania Ave Unit LLC
Wilmington, DE 19806-1392
Phone
(302) 213-6158
Fax
(855) 530-2764
NPI assigned
Apr 3, 2013
Last updated
Sep 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Q3-001083 DE Primary

Addresses

Primary practice location

2300 Pennsylvania Ave Unit LLC
Wilmington, DE 19806-1392

Mailing address

2300 Pennsylvania Ave Unit LLC
Wilmington, DE 19806-1392
Phone (302) 213-6158

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

State licenses

LicenseStateTypeSpecialty
Q3-001083DEMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Introspection Counseling Center LLC CurrentSince Sep 28, 2025 Accepting new patients

Locations

2300 Pennsylvania Ave
Unit Llc
Wilmington, DE 19806
Phone (302) 213-6158

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1205179769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 PENNSYLVANIA AVE UNIT LLC",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198061392",
            "telephone_number": "302-213-6158",
            "fax_number": "855-530-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PENNSYLVANIA AVE UNIT LLC",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198061392",
            "telephone_number": "302-213-6158",
            "fax_number": "855-530-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "GLEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DE",
            "license": "Q3-001083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.