Active NPI
Glenn C House, LLPC/LLMFT
- Professional Counselor
- Jackson, MI
National Provider Identifier
1629411467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 601013113
- Practice address
- 4886 Scarborough St
Jackson, MI 49201-9012 - Phone
- (517) 392-0366
- NPI assigned
- Apr 11, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 601013113 | MI | Primary |
| Marriage & Family Therapist | 106H00000X | 4101006535 | MI |
Addresses
Primary practice location
4886 Scarborough St
Jackson, MI 49201-9012
Mailing address
4886 Scarborough St
Jackson, MI 49201-9012
Phone (517) 392-0366
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 601013113 | MI | MD | Professional Counselor |
| 4101006535 | MI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1629411467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4886 SCARBOROUGH ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019012",
"telephone_number": "517-392-0366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4886 SCARBOROUGH ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019012",
"telephone_number": "517-392-0366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSE",
"first_name": "GLENN",
"middle_name": "C",
"credential": "LLPC/LLMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-11",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "601013113",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101006535",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.