Individual provider Active NPI

John Thomas Glacken, LISW-SUPV

  • Social Worker
  • Columbus, OH
National Provider Identifier
1336654961
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I-194 Issued in OH
Practice address
1971 W 5TH Ave Ste 2
Columbus, OH 43212
Phone
(614) 488-6285
NPI assigned
Dec 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I-194 OH Primary

Addresses

Primary practice location

1971 W 5TH Ave Ste 2
Columbus, OH 43212

Mailing address

1971 W 5TH Ave Ste 2
Columbus, OH 43212-1905
Phone (614) 488-6285

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-194OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
John M. Showalter Dba Consulting Psychological Services Past 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.

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1336654961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 W 5TH AVE STE 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432121905",
            "telephone_number": "614-488-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 W 5TH AVE STE 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43212",
            "telephone_number": "614-488-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLACKEN",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "LISW-SUPV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-05",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I-194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.