Emily Nicole Glickman
Individual provider Active NPI Marriage & Family Therapist · Oak Park, CA
NPI 1306235809 · NPPES record last updated Jul 6, 2020
Key facts
- NPI
- 1306235809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 114279 (CA)
- Practice address
- 6259 Smoke Tree Ave
Oak Park, CA 91377-1149 - Phone
- (818) 268-2170
- NPI assigned
- Jan 21, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250317003285 | CA | Practitioner - Marriage and Family Therapist | 5698297877 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Behavioral Health Inc | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
993 W 7th St
Oxnard, CA 93030
Phone (805) 483-9565
1500 Palma Dr
Ste 2
Ventura, CA 93003
1500 Palma Dr
Fl 2
Ventura, CA 93003
Phone (805) 284-1783
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 114279 | CA | Yes |
Addresses
Primary practice location
6259 Smoke Tree Ave
Oak Park, CA 91377-1149
Mailing address
6259 Smoke Tree Ave
Oak Park, CA 91377-1149
Phone (818) 268-2170
Other providers in Oak Park, CA
- Stacey Mandel Garfinkel
- Alice Kate Geisman
- Raina Ghajar
- Theresa Gillibrand
- Marissa Leigh Gilmore
- Joseph Guidetti
- Paul Hahn
- Chad Daniel Hampton
- Katrina Hanna
- Gary Thomas Hardeman
All providers in Oak Park, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.