Terry Glenn

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.011987 Issued in IL

Practice address

2148 Vadalabene Dr
Maryville, IL 62062-5632

Phone

(618) 288-3100

Fax

(618) 288-3371

NPI assigned

Sep 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Chestnut Health Systems IncGroup PAC ID 1052393063, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chestnut Health Systems Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bloomington, IL
  • NPI 1366431686

  IL

  Medicare reassignment Care Compare group NPD
• Chestnut Health Systems Inc.

  • Federally Qualified Health Center (FQHC)
  • Bloomington, IL
  • NPI 1225740756
  Care Compare group
• Chestnut Health Systems Inc.

  • Federally Qualified Health Center (FQHC)
  • Belleville, IL
  • NPI 1801508544
  Care Compare group
• Chestnut Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Granite City, IL
  • NPI 1326417080
  Care Compare group
• Chestnut Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Bloomington, IL
  • NPI 1790055952
  Care Compare group
• Chestnut Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Maryville, IL
  • NPI 1467174177
  Care Compare group
• Chestnut Health Systems Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wood River, IL
  • NPI 1235941311
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1699316877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 WYLIE DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615405",
            "telephone_number": "309-820-3744",
            "fax_number": "309-451-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625632",
            "telephone_number": "618-288-3100",
            "fax_number": "618-288-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "TERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.001987",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.011987",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.011987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
• Anna Joy Gerlach, LPC
• Jessica Leigh Gibson, PA-C
• Nathan John Gibson, PT
• Aaliyah Gladney, AUD
• Cameron Gordineer, DC
• Marie Graham
• Brett R Grebing, MD
• Rodney L. Greeling, DO
• Gronemeyer Bell Counseling Services, PLLC

• All providers in Maryville, IL
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.