Thomas George Glaza, M.A., M. ED

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

MH5146 Issued in FL

Practice address

12497 Tamiami TRL S
Suite #9
North Port, FL 34287-1447

Phone

(941) 429-0804

Fax

(941) 429-0814

NPI assigned

Dec 28, 2005

Last updated

Jul 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education, Master of Arts

State licenses

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1548247968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2763 S SAN MATEO DR",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342888266",
            "telephone_number": "941-426-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12497 TAMIAMI TRL S",
            "address_2": "SUITE #9",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342871447",
            "telephone_number": "941-429-0804",
            "fax_number": "941-429-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZA",
        "first_name": "THOMAS",
        "middle_name": "GEORGE",
        "credential": "M.A., M. ED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "2188",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH5146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MH5146",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP CERTIFICATE",
            "identifier": "2188",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in North Port, FL
• Providers in North Port, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.