Glow Therapeutic Services of Kentucky, LLC

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

Organization subpart

No

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

Authorized official

Name

Ms. Marissa S Hubert, LCSW, CADC

Title

Outpatient Therapist

Phone

(812) 453-8543

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "P400019932",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30603013",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Kay Glahn, PT
• Christopher C Glaser, MD
• Shannon B. Gleason, APRN
• Kathleen A Glenn, PA
• Stevie Glenn
• Elizabeth Anne Godthaab
• Eric Alan Goebel, MD
• Ashley R Goedde, APRN
• Stephanie Goerz, LPCA
• Caleb Goetz

• Community/Behavioral Health Agency in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Community/Behavioral Health Agency in Kentucky

• 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.