Active NPI
Julie Glynn
- Clinical Social Worker
- Hayward, WI
National Provider Identifier
1245611698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8262
- Practice address
- 10752 Beal Ave
Hayward, WI 54843-6435 - Phone
- (715) 634-0222
- Fax
- (715) 634-1722
- NPI assigned
- Jun 11, 2015
- Last updated
- Jun 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8262 | WI | Primary |
Addresses
Primary practice location
10752 Beal Ave
Hayward, WI 54843-6435
Mailing address
10752 Beal Ave
Hayward, WI 54843-6435
Phone (715) 634-0222
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 |
|---|---|---|---|
| 8262 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northland Counseling Services LTD | Clinical | Past | 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, 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": "1433980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433980800000",
"number": "1245611698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10752 BEAL AVE",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548436435",
"telephone_number": "715-634-0222",
"fax_number": "715-634-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10752 BEAL AVE",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548436435",
"telephone_number": "715-634-0222",
"fax_number": "715-634-1722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLYNN",
"first_name": "JULIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-11",
"last_updated": "2015-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "8262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.