Active NPI
Rebecca Glose, LCSW
- Clinical Social Worker
- Longview, WA
National Provider Identifier
1326585100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 720 14TH Avenue
Longview, WA 98632 - Phone
- (360) 423-0203
- Fax
- (360) 423-5086
- NPI assigned
- Jan 31, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 60733947 | WA | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
720 14TH Avenue
Longview, WA 98632
Mailing address
921 14TH Avenue
Longview, WA 98632
Phone (360) 423-0203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2107795 | Medicaid | WA |
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 |
|---|---|---|---|
| 60733947 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Mental Health and Parenting Support PLLC | Clinical | Current | 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 and National Provider Directory roles.
-
- Clinical Social Worker
- Vancouver, WA
- NPI 1720785660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1326585100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "921 14TH AVENUE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "98632",
"telephone_number": "360-423-0203",
"fax_number": "360-577-0269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 14TH AVENUE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "98632",
"telephone_number": "360-423-0203",
"fax_number": "360-423-5086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOSE",
"first_name": "REBECCA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-31",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "60733947",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2107795",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.