Cameron Michael Glick

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

780 American Legion Hwy
Roslindale, MA 02131-3908

Phone

(617) 267-3700

NPI assigned

Oct 27, 2022

Reactivated

Sep 10, 2024

Last updated

Oct 16, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1447977624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "888-922-2843",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "617-267-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Canal St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142018",
            "country_code": "US",
            "telephone_number": "888-922-2843",
            "fax_number": "855-568-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLICK",
        "first_name": "CAMERON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-27",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "deactivation_date": "2024-08-30",
        "reactivation_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Carleen Gerald, MD
• Myriame Germain
• Susan Geronimus, LICSW
• Rick Gershberg, PH.D.
• Eric Getkin, P.T.
• Karissa Gokarn, RD, LDN, CDCES
• Cristina Gonzalez
• Julian R Gonzalez, MD
• Niko Gonzalez
• Adam Goodman

• Behavior Technician in Roslindale, MA
• Providers in Roslindale, MA by specialty
• Behavior Technician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.