Active NPI
Glory Sistar Yancy
- Pastoral Counselor
- Clovis, NM
National Provider Identifier
1245094846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- BCCC0014
- Practice address
- 1325 Stratford LN
Clovis, NM 88101-4917 - Phone
- (501) 502-6676
- NPI assigned
- Feb 13, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Religious Nonmedical Practitioner | 374K00000X | |||
| Pastoral Counselor | 101YP1600X | BCCC0014 | NM | Primary |
Addresses
Primary practice location
1325 Stratford LN
Clovis, NM 88101-4917
Mailing address
1325 Stratford LN
Clovis, NM 88101-4917
Phone (501) 502-6676
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
| License | State | Type | Specialty |
|---|---|---|---|
| BCCC0014 | NM | MD | Pastoral Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christian Believers Education | Pastoral | Current | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1245094846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 STRATFORD LN",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881014917",
"telephone_number": "501-502-6676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 STRATFORD LN",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881014917",
"telephone_number": "501-502-6676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANCY",
"first_name": "GLORY",
"middle_name": "SISTAR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-13",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "374K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Religious Nonmedical Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "NM",
"license": "BCCC0014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.