Shaela Glade, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

276750-6004 Issued in UT

Practice address

663 W 950 S
Brigham City, UT 84302-3021

Phone

(435) 734-9449

NPI assigned

Mar 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Credentials

Master of Science

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 and National Provider Directory roles.

• Bear River Mental Health Services Inc

  • Mental Health Counselor
  • Logan, UT
  • NPI 1285736553
  Medicare reassignment NPD

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1366766750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 W 950 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023021",
            "telephone_number": "435-734-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 W 950 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023021",
            "telephone_number": "435-734-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADE",
        "first_name": "SHAELA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "276750-6004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366766750",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Gifford
• Esmeralda Gil
• Madeline Gill
• Gage Girod
• De'Vary Givens
• Kenneth Robert Glodo III
• Carl Glore
• Rebecca Goble
• Julie Godderidge, REGISTERED NURSE
• Britain Godfrey

• Mental Health Counselor in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.