Glacier Lily Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GLACIER LILY THERAPY LLC

Practice address

2625 Redwing Rd Ste 230
Fort Collins, CO 80526-2804

Phone

(970) 620-8188

NPI assigned

Oct 30, 2024

Organization subpart

No

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

Authorized official

Name

Lia Wolfe, LCSWNPI 1699508911

Title

Owner

Phone

(970) 620-8188

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Tax ID family

Glacier Lily Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Glacier Lily Therapy LLC

  • Clinical Social Worker
  • Fort Collins, CO
  • NPI 1447182464
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lia Wolfe, LCSW

  • Clinical Social Worker
  • Fort Collins, CO
  • NPI 1699508911
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1487476438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 DERBY CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 REDWING RD STE 230",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262804",
            "telephone_number": "970-620-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER LILY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "LIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-620-8188",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Gittings
• Summer Giubbini, MEDICAL ASSISTANT
• Jaclyn Giunta, PHARMD
• Jennifer Lynn Giunta, R.N.
• Glacier Lily Therapy LLC
• Pete Gladstone, PH.D.
• David Glantz
• Jakiyahj Jalia Glasco
• Amy Lynn Latendresse Glaser, DPT
• Jessica Glaser, BA

• Clinical Social Worker in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.