Individual provider Active NPI

Mary Taylor Glovak, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1679272918
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904014800 Issued in VA
Practice address
1642 Pleasure House Rd Ste 102
Virginia Beach, VA 23455-4050
Phone
(757) 578-2985
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 257485 KY
Clinical Social Worker 1041C0700X 0904014800 VA Primary

Addresses

Primary practice location

1642 Pleasure House Rd Ste 102
Virginia Beach, VA 23455-4050

Mailing address

1642 Pleasure House Rd Ste 102
Virginia Beach, VA 23455-4050

Other practice location 1

264 Fernwood Farms Rd
Chesapeake, VA 23320-6930
Phone (757) 620-0773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20230411001996 VA Practitioner - Clinical Social Worker 9133594815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Wholehearted CounselingGroup PAC ID 5597011007, 10 clinicians

Practice addresses (Care Compare)

1642 Pleasure House Rd
Suite 102
Virginia Beach, VA 23455-4050
Phone (757) 578-2985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
257485KYMDClinical Social Worker
0904014800VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wholehearted Counseling Clinical CurrentSince Mar 6, 2023 Accepting new patients

Locations

1642 Pleasure House Rd
Ste 102
Virginia Beach, VA 23455
Phone (757) 578-2985

4433 Corporation Ln
Ste 175
Virginia Beach, VA 23462
Phone (757) 578-2985

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1679272918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 PLEASURE HOUSE RD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234554050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 PLEASURE HOUSE RD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234554050",
            "telephone_number": "757-578-2985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "264 Fernwood Farms Rd",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233206930",
            "country_code": "US",
            "telephone_number": "757-620-0773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVAK",
        "first_name": "MARY",
        "middle_name": "TAYLOR",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257485",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.