Glenn Cockrell, LCSW, LAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

913 Issued in MT

Practice address

1325 Wyoming St
Missoula, MT 59801-1725

Phone

(406) 532-9800

Fax

(406) 541-3032

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1245453950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "T-9 FORT MISSOULA",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047202",
            "telephone_number": "406-532-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WYOMING ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011725",
            "telephone_number": "406-532-9800",
            "fax_number": "406-541-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKRELL",
        "first_name": "GLENN",
        "credential": "LCSW, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1190",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grayson Wells Cobb, MD
• Joshua Christopher Cobb
• Douglas Shepard Cochran-Roberts, LCPC
• Bryan Neil Cochran, PH.D.
• Michael Ward Cochrane, BA, LAC
• Cocreations LLC (Elise Watts)
• Coe a Dolven
• Cogent Healthcare of Montana P C
• Alaina Cole
• Christine Ann Cole

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.