Individual provider Active NPI

Randy S Glasscock

  • Mental Health Counselor
  • Pleasant Valley, WV
National Provider Identifier
1740032960
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2853 Issued in WV
Practice address
2420 Serene LN
Pleasant Valley, WV 26554
Phone
(304) 376-9693
NPI assigned
Apr 2, 2024
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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 2853 WV Primary

Addresses

Primary practice location

2420 Serene LN
Pleasant Valley, WV 26554

Mailing address

2420 Serene Dr
Pleasant Valley, WV 26554-0909
Phone (304) 376-9693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20240729001655 WV Practitioner - Mental Health Counselor 4385180124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
West Virginia University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grandw IncGroup PAC ID 9739324922, 93 clinicians

Practice addresses (Care Compare)

120 Professional PL
Bridgeport, WV 26330-4599
Phone (304) 460-5123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2853WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
GR&W, Inc CurrentSince Jun 17, 2024 Accepting new patients
GR&W, Inc PastSince Nov 18, 2025 Accepting new patients

Locations

120 Professional Pl
Bridgeport, WV 26330
Phone (681) 214-0101

120 Professional Pl
Ste 101
Bridgeport, WV 26330
Phone (304) 369-8878

1005 White Willow Way
Morgantown, WV 26505
Phone (304) 212-7238

1100 Main St
Ste 104
Wheeling, WV 26003
Phone (304) 443-1414

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1740032960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 SERENE DR",
            "city": "PLEASANT VALLEY",
            "state": "WV",
            "postal_code": "265540909",
            "telephone_number": "304-376-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 SERENE LN",
            "city": "PLEASANT VALLEY",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-376-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSCOCK",
        "first_name": "RANDY",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-02",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Valley, WV

Sources for this page

Verify at the official NPI Registry.