Active NPI
Glynis Marie Phillips
- Addiction (Substance Use Disorder) Counselor
- Inglewood, CA
National Provider Identifier
1497975205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 614 W Manchester Blvd
#104
Inglewood, CA 90301 - Phone
- (310) 412-0879
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
614 W Manchester Blvd
#104
Inglewood, CA 90301
Mailing address
614 W Manchester Blvd
#104
Inglewood, CA 90301
Phone (310) 412-0879
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7006 | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510185600000",
"number": "1497975205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 W MANCHESTER BLVD",
"address_2": "#104",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "90301",
"telephone_number": "310-412-0879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 W MANCHESTER BLVD",
"address_2": "#104",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "90301",
"telephone_number": "310-412-0879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "GLYNIS",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2017-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7006",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Inglewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.