Edward Richard Allen Glass Jr., LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH-15511 Issued in FL

Practice address

8057 Kilwinning LN
Jacksonville, FL 32244-5500

Phone

(904) 655-5440

NPI assigned

Feb 7, 2020

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1487286365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8057 KILWINNING LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445500",
            "telephone_number": "904-655-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8057 KILWINNING LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445500",
            "telephone_number": "904-655-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "EDWARD",
        "middle_name": "RICHARD ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH-15511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glam Therapy
• Latoya Glanton
• Erika Dawn Glas, D.O.
• Shirley D Glasgow, L.M.T.
• Anissa Glass, PHARM D
• Gracie Glass
• Joshua Glassberg, RN
• Haley Danae Glasser, DNP, FNP-C
• Theodore G Glasser, MD
• Adam Ryan Glassick, PA-C

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.