Active NPI
Sara Jeanne Glenn
- Clinical Social Worker
- Laramie, WY
National Provider Identifier
1669214433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1164
- Practice address
- 605 Skyline Rd Ste 101
Laramie, WY 82070-8909 - Phone
- (307) 460-2771
- NPI assigned
- Jun 11, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1164 | WY | Primary |
Addresses
Primary practice location
605 Skyline Rd Ste 101
Laramie, WY 82070-8909
Mailing address
605 Skyline Rd Ste 101
Laramie, WY 82070-8909
Phone (307) 460-2771
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 |
|---|---|---|---|
| 1164 | WY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1669214433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 SKYLINE RD STE 101",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820708909",
"telephone_number": "307-460-2771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 SKYLINE RD STE 101",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820708909",
"telephone_number": "307-460-2771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "SARA",
"middle_name": "JEANNE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-11",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WY",
"license": "1164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.