Active NPI
Leslie K Glenn, LCMHC
- Professional Counselor
- Leeds, UT
National Provider Identifier
1710197389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 47998256004
- Practice address
- 654 W Canyon Creek Dr
Leeds, UT 84746 - Phone
- (435) 652-4596
- NPI assigned
- May 23, 2007
- Last updated
- Feb 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4540 | MA | |
| Professional Counselor | 101YP2500X | 47998256004 | UT | Primary |
Addresses
Primary practice location
654 W Canyon Creek Dr
Leeds, UT 84746
Mailing address
PO Box 461144
Leeds, UT 84746-1144
Phone (435) 652-4596
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4540 | MA | MD | Mental Health Counselor |
| 47998256004 | UT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423526400000",
"number": "1710197389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 461144",
"city": "LEEDS",
"state": "UT",
"postal_code": "847461144",
"telephone_number": "435-652-4596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "654 W CANYON CREEK DR",
"city": "LEEDS",
"state": "UT",
"postal_code": "84746",
"telephone_number": "435-652-4596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "LESLIE",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2015-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4540",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "UT",
"license": "47998256004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leeds, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.