Individual provider Active NPI

Stanley Glick, LCSW

  • Clinical Social Worker
  • Langhorne, PA
National Provider Identifier
1437133568
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW000778L Issued in PA
Practice address
412 Executive Dr
Langhorne, PA 19047-8003
Phone
(215) 321-1435
Fax
(215) 369-8258
NPI assigned
Dec 2, 2005
Last updated
Dec 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW000778L PA Primary
Clinical Social Worker 1041C0700X 44SC00078900 NJ

Addresses

Primary practice location

412 Executive Dr
Langhorne, PA 19047-8003

Mailing address

412 Executive Dr
Langhorne, PA 19047-8003
Phone (215) 321-1435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061219000006 PA Practitioner - Clinical Social Worker 8729087861 Reassigns benefits to 1 organization
I20070313000064 NJ Practitioner - Clinical Social Worker 8729087861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Herrontown Rd
Princeton, NJ 08540-7716
Phone (609) 683-8399

412 Executive Dr
Langhorne, PA 19047-8003
Phone (215) 321-1435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00078900NJMDClinical Social Worker

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, 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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1437133568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 EXECUTIVE DR",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190478003",
            "telephone_number": "215-321-1435",
            "fax_number": "215-369-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 EXECUTIVE DR",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190478003",
            "telephone_number": "215-321-1435",
            "fax_number": "215-369-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "STANLEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW000778L",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00078900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.