Jennifer Lauren Glickstein, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

202132 Issued in MN

Practice address

490 Highway 96 W
Shoreview, MN 55126-1960

Phone

(651) 451-3016

NPI assigned

Sep 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Lauren Bernick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Kids Abilities, Inc

  • Clinic/Center
  • Shoreview, MN
  • NPI 1154455616
  NPD (past)

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1629587142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 96 W",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 96 W",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261960",
            "telephone_number": "651-451-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKSTEIN",
        "first_name": "JENNIFER",
        "middle_name": "LAUREN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "202132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BERNICK",
            "middle_name": "LAUREN",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Geneva Recovery LLC
• Penny Sue Giesbrecht, PSY.D., L.P.
• Carol Gilligan, PT
• Tara Gillis, LMFT
• Richard D. Glasow, MD
• Janice Chua Go, MD
• Brianna Lynne Gohdes, PHARMD, RPH
• Jazzmyn Goldsmith, LMFT
• Golf Transportation LLC
• Bradley Denver Goodell Jr., PSY.D.

• Occupational Therapy Assistant in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Occupational Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; 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.