Individual provider Active NPI

Glenna M. Tibbs, LMHC

  • Mental Health Counselor
  • Cape Coral, FL
National Provider Identifier
1679610836
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7445 Issued in FL
Practice address
923 Del Prado Blvd
Suite 205
Cape Coral, FL 33990-3652
Phone
(239) 464-0570
Fax
(239) 242-6389
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH7445 FL Primary

Addresses

Primary practice location

923 Del Prado Blvd
Suite 205
Cape Coral, FL 33990-3652

Mailing address

418 SW 43Rd LN
Cape Coral, FL 33914-7520
Phone (239) 549-4346

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

LicenseStateTypeSpecialty
MH7445FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
I-Bos Counseling Center, LLC Mental Health PastSince Sep 1, 2021 Accepting new patients

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679610836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 SW 43RD LN",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339147520",
            "telephone_number": "239-549-4346",
            "fax_number": "239-242-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 DEL PRADO BLVD",
            "address_2": "SUITE 205",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903652",
            "telephone_number": "239-464-0570",
            "fax_number": "239-242-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "GLENNA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.