Glory A Wanless

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

10787 W Ustick Rd
Boise, ID 83713-5104

Phone

(208) 672-1801

Fax

(855) 212-5682

NPI assigned

Jul 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 2, 2024 through Apr 2, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Ashwood Recovery LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boise, ID
  • NPI 1043545106
  NPD (past)
• Ashwood Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Boise, ID
  • NPI 1801452677
  NPD (past)
• Boise Counseling Center, LLC

  • Professional Counselor
  • Boise, ID
  • NPI 1760081459
  NPD (past)

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1750990644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S TOPAZ WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10787 W USTICK RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135104",
            "telephone_number": "208-672-1801",
            "fax_number": "855-212-5682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "847 Parkcentre Way Ste 7",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836511794",
            "country_code": "US",
            "telephone_number": "208-229-6050",
            "fax_number": "855-212-5682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7941 W Rifleman St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837049001",
            "country_code": "US",
            "telephone_number": "208-895-7950",
            "fax_number": "855-212-5682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANLESS",
        "first_name": "GLORY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ying Wang, L.AC.,O.M.D.
• Kaylee Wangelin, LMSW
• Patrick Kitambo Wangoi
• Christopher Mwaniki Wanjiku, MD
• Owais Wanker
• Amy War, D.P.T.
• Jenna Marie Warbritton, LCSW, MSW
• Ryan Warburton, DPT
• Brandon Garland Ward, RN
• Brittney Ward, BCBA

• Professional Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.