NPIMap

Organization Active NPI

Glow Therapeutic Services of Kentucky, LLC

  • Community/Behavioral Health Agency
  • Owensboro, KY
National Provider Identifier
1306289293
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
3407 Issued in KY
Legal business name
GLOW THERAPEUTIC SERVICES OF KENTUCKY, LLC
Practice address
210 W 3Rd St
Owensboro, KY 42303-4121
Phone
(812) 453-8543
Fax
(270) 906-1150
NPI assigned
Apr 10, 2013
Last updated
Oct 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Authorized official

Name
Ms. Marissa S Hubert, LCSW, CADCNPI 1003961814
Title
Outpatient Therapist
Phone
(812) 453-8543

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 3407 KY Primary
Community/Behavioral Health Agency 251S00000X 0981 KY

Addresses

Primary practice location

210 W 3Rd St
Owensboro, KY 42303-4121

Mailing address

210 W 3Rd St
Owensboro, KY 42303-4121
Phone (812) 453-8543

National Provider Directory

National Provider Directory

Locations

210 W 3rd St
Owensboro, KY 42303
Phone (812) 453-8543

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1306289293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 3RD ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423034121",
            "telephone_number": "812-453-8543",
            "fax_number": "270-906-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 3RD ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423034121",
            "telephone_number": "812-453-8543",
            "fax_number": "270-906-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW THERAPEUTIC SERVICES OF KENTUCKY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "HUBERT",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OUTPATIENT THERAPIST",
        "authorized_official_telephone_number": "812-453-8543",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, CADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": "3407",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": "0981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.