Active NPI
Reba Glidewell, PHD
- Clinical Psychologist
- Larned, KS
National Provider Identifier
1366495731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1255
- Practice address
- 1301 KS Hwy 264
Larned, KS 67550-9365 - Phone
- (620) 285-4022
- Fax
- (620) 285-4249
- NPI assigned
- May 18, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1255 | KS | Primary |
Addresses
Primary practice location
1301 KS Hwy 264
Larned, KS 67550-9365
Mailing address
1301 KS Hwy 264
Larned, KS 67550-9365
Phone (620) 285-4022
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 564 | NE | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Nebraska Dept of Admin 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.
-
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- Beatrice, NE
- NPI 1114085826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366495731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 KS HWY 264",
"city": "LARNED",
"state": "KS",
"postal_code": "675509365",
"telephone_number": "620-285-4022",
"fax_number": "620-285-4249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 KS HWY 264",
"city": "LARNED",
"state": "KS",
"postal_code": "675509365",
"telephone_number": "620-285-4022",
"fax_number": "620-285-4249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLIDEWELL",
"first_name": "REBA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "1255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Larned, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.