Individual provider Active NPI

Dennis J Glandon, CSW LPC

  • Social Worker
  • Jackson, MI
National Provider Identifier
1366496051
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801016082 Issued in MI
Practice address
1200 N West Ave
Suite 400
Jackson, MI 49202-2179
Phone
(517) 780-3336
Fax
(517) 796-4561
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801016082 MI Primary
Social Worker 104100000X 6301002109 MI

Addresses

Primary practice location

1200 N West Ave
Suite 400
Jackson, MI 49202-2179

Mailing address

1200 N West Ave
Suite 400
Jackson, MI 49202-2179
Phone (517) 780-3336

Other identifiers 2

IdentifierTypeStateIssuer
041285OtherMIVALUE OPTOINS STATE OF MI
8008970870OtherMITRADITIONAL BLUE CROSS B

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

LicenseStateTypeSpecialty
6301002109MIMDSocial Worker
6801016082MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1366496051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3336",
            "fax_number": "517-796-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3336",
            "fax_number": "517-796-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANDON",
        "first_name": "DENNIS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "CSW LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801016082",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6301002109",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTOINS STATE OF MI",
            "identifier": "041285",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRADITIONAL BLUE CROSS B",
            "identifier": "8008970870",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.