Active NPI
Glen Eugene Stovall, M.S.W.
- Clinical Social Worker
- Salina, KS
National Provider Identifier
1689618514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSCSW 1078
- Practice address
- 645 E Iron Ave
Suite D
Salina, KS 67401-2697 - Phone
- (785) 827-2700
- Fax
- (785) 309-0184
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- 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 | LSCSW 1078 | KS | Primary |
Addresses
Primary practice location
645 E Iron Ave
Suite D
Salina, KS 67401-2697
Mailing address
645 E Iron Ave
Suite D
Salina, KS 67401-2697
Phone (785) 827-2700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91946 | Other | KS | MANAGED HEALTH NETWORK |
| 32748 | Other | KS | CIGNA |
| 100097970A | Medicaid | KS | |
| 011556 | Other | KS | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSCSW 1078 | KS | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diane L Geisen, Lscsw, LLC | Clinical | Past | Accepting new patients |
| Darlys E. Willer, Lscsw | Past | Accepting new patients | |
| E Medical Group of Kansas No. 5, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Salina, KS
- NPI 1063789451
-
- Clinical Social Worker
- Salina, KS
- NPI 1962961540
-
- Home Health Agency
- Wakeeney, KS
- NPI 1649720012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1689618514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 E IRON AVE",
"address_2": "SUITE D",
"city": "SALINA",
"state": "KS",
"postal_code": "674012697",
"telephone_number": "785-827-2700",
"fax_number": "785-309-0184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 E IRON AVE",
"address_2": "SUITE D",
"city": "SALINA",
"state": "KS",
"postal_code": "674012697",
"telephone_number": "785-827-2700",
"fax_number": "785-309-0184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVALL",
"first_name": "GLEN",
"middle_name": "EUGENE",
"credential": "M.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "LSCSW 1078",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "91946",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "32748",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100097970A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "011556",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salina, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.