NPIMap

Individual provider Active NPI

Susan D Glenn, MA, BCBA, COBA

  • Behavior Analyst
  • Strongsville, OH
National Provider Identifier
1487201711
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-58206
Practice address
22600 Ascoa CT
Strongsville, OH 44149-4700
Phone
(440) 870-2122
Fax
(216) 208-1475
NPI assigned
Aug 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-58206 Primary

Addresses

Primary practice location

22600 Ascoa CT
Strongsville, OH 44149-4700

Mailing address

23220 Chagrin Blvd Apt 140
Beachwood, OH 44122-5421
Phone (317) 225-9119

Other practice location 1

23220 Chagrin Blvd Apt 140
Beachwood, OH 44122-5421
Phone (317) 225-9119

Other names 1

  • Ms. Susan Som Former name

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Supersonic ABA LLC Behavior Analyst CurrentSince Aug 13, 2023 Accepting new patients
Heartlinks ABA in LLC Behavior Analyst Past Accepting new patients
Target ABA Behavior Analyst PastSince Jul 2, 2023 Accepting new patients
Stepping Stones Behavioral Solutions LLC Behavior Analyst PastSince May 1, 2022 Accepting new patients
Hopebridge, LLC Behavior Analyst PastSince Aug 1, 2019 Accepting new patients

Locations

22600 Ascoa Ct
Strongsville, OH 44149
Phone (216) 260-4847

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1487201711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23220 CHAGRIN BLVD APT 140",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225421",
            "telephone_number": "317-225-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22600 ASCOA CT",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441494700",
            "telephone_number": "440-870-2122",
            "fax_number": "216-208-1475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23220 Chagrin Blvd Apt 140",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225421",
            "country_code": "US",
            "telephone_number": "317-225-9119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "SUSAN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MA, BCBA, COBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-22-58206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SOM",
            "prefix": "MS.",
            "credential": "MA, BCBA, COBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Strongsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.