Active NPI
Robert Jay Glick, MA
- Professional Counselor
- Decatur, GA
National Provider Identifier
1558928796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC012974
- Practice address
- 450 Winn Way
Decatur, GA 30030-1715 - Phone
- (404) 294-3745
- NPI assigned
- May 23, 2019
- Last updated
- Jul 27, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC012974 | GA | Primary |
Addresses
Primary practice location
450 Winn Way
Decatur, GA 30030-1715
Mailing address
450 Winn Way
Decatur, GA 30030-1715
Other practice location 1
1605 Morgans Landing Dr
Atlanta, GA 30350-4828
Phone (678) 642-1503
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC012974 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1558928796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 WINN WAY",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 WINN WAY",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301715",
"telephone_number": "404-294-3745"
}
],
"practiceLocations": [
{
"address_1": "1605 Morgans Landing Dr",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303504828",
"country_code": "US",
"telephone_number": "678-642-1503",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLICK",
"first_name": "ROBERT",
"middle_name": "JAY",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-23",
"last_updated": "2023-07-27",
"certification_date": "2023-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC012974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
- Lauren Gleason, RD
- Courtney Glenn, LCSW
- Subrena Ann Glenn
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- Glenwood Operating Company LLC (Glenwood Health and Rehabilitation Center)
- Tankia Glover, OTR/L
- GM Medical Services LLC (Candler Pharmacy)
- Justina Adele Gniot
- Leigh Caroline Gobbel, L.C.S.W.
- Mark Tilden Gobbel, D.M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.