Active NPI
Glen Ryan Sargent, MSED., LPCC
- Professional Counselor
- Reynoldsburg, OH
National Provider Identifier
1487108742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.1901524
- Practice address
- 880 Ruskin Dr
Reynoldsburg, OH 43068-1359 - Phone
- (614) 551-0370
- NPI assigned
- Aug 4, 2016
- Reactivated
- Mar 30, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.1901524 | OH | Primary |
Addresses
Primary practice location
880 Ruskin Dr
Reynoldsburg, OH 43068-1359
Mailing address
880 Ruskin Dr
Reynoldsburg, OH 43068-1359
Phone (614) 551-0370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1473276 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| E.1901524 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648598400000",
"number": "1487108742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "880 RUSKIN DR",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "430681359",
"telephone_number": "614-551-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "880 RUSKIN DR",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "430681359",
"telephone_number": "614-551-0370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARGENT",
"first_name": "GLEN",
"middle_name": "RYAN",
"name_prefix": "Mr.",
"credential": "MSED., LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-04",
"last_updated": "2022-03-30",
"certification_date": "2022-03-30",
"deactivation_date": "2021-11-26",
"reactivation_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.1901524",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1473276",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reynoldsburg, OH
- Sam's Club Optical (Sam's Club Optical 30-6326)
- Sams East Inc (Sams Pharmacy 10-6326)
- Deborah N Sanders, LPN
- Lawrence Labert Sandor, R.PH.
- Riza Sanyasi, CMA
- Wendy Sarpong, MSN FNP-C
- Savory Home Healthcare Services, LLC
- Savory Home Healthcare Services, LLC
- Vanessa Scales, RN
- Sceptre Health Care Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.