Individual provider Active NPI

Juan Ignacio Glenn, M.A., LMTF

  • Marriage & Family Therapist
  • Westminster, CO
National Provider Identifier
1659756989
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
109529 Issued in CA
Practice address
11245 Huron St
Westminster, CO 80234-2806
Phone
(303) 338-4545
NPI assigned
Jul 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0001853 CO
Marriage & Family Therapist 106H00000X IMF86996 CA
Marriage & Family Therapist 106H00000X 109529 CA Primary

Addresses

Primary practice location

11245 Huron St
Westminster, CO 80234-2806

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other names 1

  • Juan Ignacio Soneyra Ossola Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116001000 CO Practitioner - Marriage and Family Therapist 2163874181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
109529CAMDClinical Social Worker
IMF86996CAMDMarriage & Family Therapist
0001853COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. CurrentSince Jan 1, 2024 Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

11245 Huron St
Westminster, CO 80234
Phone (303) 451-9494

7701 Sheridan Blvd
Westminster, CO 80003
Phone (303) 471-7700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1659756989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11245 HURON ST",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342806",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "JUAN",
        "middle_name": "IGNACIO",
        "credential": "M.A., LMTF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "0001853",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF86996",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11245 Huron St",
            "city": "Westminster",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802342806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "SONEYRA OSSOLA",
            "middle_name": "IGNACIO",
            "credential": "M.A., LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.