Glenda Dematty, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61128052 Issued in WA

Practice address

2727 Hollycroft St Ste 110
Gig Harbor, WA 98335

Phone

(253) 432-6126

NPI assigned

Mar 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Glenda Elliott Professional name

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health

  Medicare reassignment NPD
• Alder Wellness & Counseling, PLLC

  • Adult Mental Health Clinic/Center
  • Gig Harbor, WA
  • NPI 1740749233
  NPD Authorized official
• Kitsap Mental Health Services

  • Community/Behavioral Health Agency
  • Bremerton, WA
  • NPI 1033268008
  NPD (past)

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1336531060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983660216",
            "telephone_number": "253-432-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HOLLYCROFT ST STE 110",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "98335",
            "telephone_number": "253-432-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTY",
        "first_name": "GLENDA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60692217",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61128052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHCA",
            "identifier": "MC60692217",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "LH61128052",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAC CREDENTIAL NUMBER",
            "identifier": "CG 60535559",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "ELLIOTT",
            "credential": "LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Melanie Renee Dean, RD
• Debra M. Enneking DDS, Inc.
• Sean Deilgat
• Evelyn Dejesus, RN
• Carole Ann Demarco, PHD
• Christin Diane Derig, AGPCNP
• Zona L Dering, RN
• Desiree Gaffney, Ma, LMHC, LLC
• Gabrielle Deucher
• Lucretia M Devine, LMHC

• Mental Health Counselor in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.