Glinda Johnson Medland, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019286 Issued in PA

Practice address

6079 Main St
East Petersburg, PA 17520-1267

Phone

(717) 560-1908

NPI assigned

Apr 18, 2007

Last updated

Oct 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Joanne Storer

  • Clinical Social Worker
  • Mountainhome, PA
  • NPI 1154681237
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1578789558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N 7TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465040",
            "telephone_number": "717-272-5464",
            "fax_number": "717-376-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6079 MAIN ST",
            "city": "EAST PETERSBURG",
            "state": "PA",
            "postal_code": "175201267",
            "telephone_number": "717-560-1908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3975 Conshohocken Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191315426",
            "country_code": "US",
            "telephone_number": "215-879-1000 x245",
            "fax_number": "215-879-3912",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1056 Rt. 390",
            "address_purpose": "LOCATION",
            "city": "Mountainhome",
            "state": "PA",
            "postal_code": "18342",
            "country_code": "US",
            "telephone_number": "570-595-0950",
            "fax_number": "570-595-0528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON MEDLAND",
        "first_name": "GLINDA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW006656L",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019289090003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Graham
• John C Grisbacher, PSY D
• Katrina Ellen Evans Harris, RNC
• Shanna Harvey
• Morgan Heisey
• Kevin William Kelly, PSY.D.
• Kyle Michale Kennedy, LCSW
• Rebecca King, LSW
• Tammy Lucas King, PSYD
• Jessica Kingeter

• Clinical Social Worker in East Petersburg, PA
• Providers in East Petersburg, PA by specialty
• Clinical Social Worker in Pennsylvania

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