Individual provider Active NPI

Jacob Michael Glose

  • Professional Counselor
  • Kansas City, MO
National Provider Identifier
1417338435
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2015017463 Issued in MO
Practice address
723 E 18TH St
Kansas City, MO 64108-1511
Phone
(636) 232-4945
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2015017463 MO Primary

Addresses

Primary practice location

723 E 18TH St
Kansas City, MO 64108-1511

Mailing address

723 E 18TH St
Kansas City, MO 64108-1511
Phone (636) 232-4945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20231222001832 AR Practitioner - Mental Health Counselor 1850600941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

102 Country Club Pkwy
Suite a
Maumelle, AR 72113-7048
Phone (501) 628-9066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015017463MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Thriveworks Telepsychiatry - Arkansas Mental Health CurrentSince May 10, 2022 Accepting new patients

Locations

102 Country Club Pkwy
Ste A
Maumelle, AR 72113
Phone (501) 628-9066

4704 W Commercial Dr
Ste A
North Little Rock, AR 72116
Phone (501) 397-1015

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1417338435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 E 18TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081511",
            "telephone_number": "636-232-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 E 18TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081511",
            "telephone_number": "636-232-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOSE",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2015017463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.