Individual provider Active NPI

Amy Catherine Glass, APRN, CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Rapids, MN
National Provider Identifier
1609752427
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13288 Issued in MN
Practice address
215 SE 2ND Ave
Grand Rapids, MN 55744-3615
Phone
(218) 326-1274
NPI assigned
Aug 15, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13288 MN Primary

Addresses

Primary practice location

215 SE 2ND Ave
Grand Rapids, MN 55744-3615

Mailing address

215 SE 2ND Ave
Grand Rapids, MN 55744-3615

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL northlandcounseling.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250912000699 MN Practitioner - Nurse Practitioner 7618470931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northland Counseling Center IncGroup PAC ID 1153389242, 25 clinicians

Practice addresses (Care Compare)

215 SE 2ND Ave
Grand Rapids, MN 55744-3615
Phone (218) 327-1151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13288MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Counseling Center, Inc. CurrentSince Sep 2, 2025 Accepting new patients

Locations

215 SE 2nd Ave
Grand Rapids, MN 55744
Phone (218) 326-1274

3130 SE 2nd Ave
Grand Rapids, MN 55744
Phone (218) 256-1131

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1609752427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615",
            "telephone_number": "218-326-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "AMY",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "APRN, CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "13288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "northlandcounseling.org",
            "affiliation": "N",
            "address_1": "215 SE 2nd Ave",
            "city": "Grand Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557443615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

Verify at the official NPI Registry.