Individual provider Active NPI

Richard B Glickstein, LCSW, LISW-CP

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1699181594
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005176 Issued in GA
Practice address
1180 Gilbert St SE
Atlanta, GA 30316-3102
Phone
(305) 613-5552
NPI assigned
Jul 11, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C0147 GA
Clinical Social Worker 1041C0700X CSW005176 GA Primary

Addresses

Primary practice location

1180 Gilbert St SE
Atlanta, GA 30316-3102

Mailing address

1180 Gilbert St SE
Atlanta, GA 30316-3102
Phone (305) 613-5552

Other names 1

  • Rich Glickstein Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140912000859 GA Practitioner - Clinical Social Worker 3274752837 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0147GAMDAddiction (Substance Use Disorder) Counselor
CSW005176GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Progress Counseling and Consulting LLC CurrentSince Dec 21, 2023 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": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1699181594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 GILBERT ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163102",
            "telephone_number": "305-613-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 GILBERT ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163102",
            "telephone_number": "305-613-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKSTEIN",
        "first_name": "RICHARD",
        "middle_name": "B",
        "credential": "LCSW, LISW-CP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "C0147",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICH",
            "last_name": "GLICKSTEIN",
            "credential": "LCSW, LISW-CP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.