Individual provider Active NPI

David M. Glickman, LPC

  • Mental Health Counselor
  • Philadelphia, PA
National Provider Identifier
1467737221
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC006052 Issued in PA
Practice address
313 S 16TH St
Philadelphia, PA 19102-4908
Phone
(215) 290-0222
NPI assigned
Oct 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC006052 PA Primary

Addresses

Primary practice location

313 S 16TH St
Philadelphia, PA 19102-4908

Mailing address

15 Sabine Ave
Narberth, PA 19072-1720
Phone (215) 290-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC006052PAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1467737221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SABINE AVE",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190721720",
            "telephone_number": "215-290-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S 16TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024908",
            "telephone_number": "215-290-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "DAVID",
        "middle_name": "M.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC006052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.