Glenn Holt

Primary specialty

Social WorkerTaxonomy code 104100000X

License

102694-1 Issued in NY

Practice address

9 4TH Ave
Bay Shore, NY 11706-7908

Phone

(631) 665-6707

Fax

(631) 665-3564

NPI assigned

Apr 23, 2018

Last updated

Apr 23, 2018By the provider in NPPES

Sex

Male

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 NY

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Island Psychiatry PCGroup PAC ID 9032490610, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Island Psychiatry, P.C.

  • Clinical Psychologist
  • Port Jefferson Station, NY
  • NPI 1609249754
  Medicare reassignment Care Compare group
• Catholic Charities of the Diocese of Rockville Centre

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bay Shore, NY
  • NPI 1124034558
  NPD (past)
• Catholic Charities of the Diocese of Rockville Centre

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Freeport, NY
  • NPI 1831110972
  NPD (past)

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1417444712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 GIBBS POND RD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672265",
            "telephone_number": "508-692-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 4TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067908",
            "telephone_number": "631-665-6707",
            "fax_number": "631-665-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "GLENN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "102694-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "102694-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelic Marie Holland, LPN
• Tanya Holland
• Katie M Holmes, LCSW, PHD
• Khiana Holmes
• Caroline Grace Holochwost
• Anastasiya Holubyeva, M.D.
• Meaghan Horan, FAMILY NP
• Diane Horton-McGinley, CCC-SLP
• Susan Horvatits
• Lawrence Gratton Howard, LAC

• Social Worker in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.