Individual provider Active NPI

Glen William Briggs, LCSW-R

  • Clinical Social Worker
  • Cheektowaga, NY
National Provider Identifier
1285730614
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R032613-1 Issued in NY
Practice address
1526 Walden Ave
Suite 400
Cheektowaga, NY 14225-4965
Phone
(716) 895-7167
Fax
(716) 332-4488
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R032613-1 NY Primary

Addresses

Primary practice location

1526 Walden Ave
Suite 400
Cheektowaga, NY 14225-4965

Mailing address

1526 Walden Ave
Suite 400
Cheektowaga, NY 14225-4965
Phone (716) 895-7167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20130418000435 NY Practitioner - Clinical Social Worker 1759527690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R032613-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie Mental Health Services Inc CurrentSince Jan 1, 2013 Accepting new patients

Locations

1526 Walden Ave
Ste 400
Cheektowaga, NY 14225
Phone (716) 895-7167

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1285730614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVE",
            "address_2": "SUITE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254965",
            "telephone_number": "716-895-7167",
            "fax_number": "716-332-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVE",
            "address_2": "SUITE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254965",
            "telephone_number": "716-895-7167",
            "fax_number": "716-332-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGGS",
        "first_name": "GLEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R032613-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.