Individual provider Active NPI

Glaser F Burkhardt IV, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1417285107
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49666 Issued in CA
Practice address
7177 Brockton Ave Ste 109
Riverside, CA 92506-2632
Phone
(951) 225-4998
Fax
(951) 729-6820
NPI assigned
Nov 18, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 49666 CA Primary
Marriage & Family Therapist 106H00000X IMF 45092 CA

Addresses

Primary practice location

7177 Brockton Ave Ste 109
Riverside, CA 92506-2632

Mailing address

7177 Brockton Ave Ste 109
Riverside, CA 92506-2632
Phone (951) 225-4998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20250515001085 CA Practitioner - Marriage and Family Therapist 1658899414 Practice locations: Riverside, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7177 Brockton Ave
Suite 109
Riverside, CA 92506-2632
Phone (951) 605-7911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMF 45092CAMDMarriage & Family Therapist
49666CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Quality Counseling With Glaser Burkhardt, LMFT, Inc Marriage & Family Therapist PastSince Feb 1, 2024 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": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1417285107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7177 BROCKTON AVE STE 109",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062632",
            "telephone_number": "951-225-4998",
            "fax_number": "951-729-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7177 BROCKTON AVE STE 109",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062632",
            "telephone_number": "951-225-4998",
            "fax_number": "951-729-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "GLASER",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-18",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49666",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 45092",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.