Kristin Glenn, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178012387 Issued in IL

Practice address

1257 E Walnut St
Suite 1
Carbondale, IL 62901-5002

Phone

(618) 351-9700

Fax

(618) 351-9701

NPI assigned

Apr 11, 2017

Last updated

Apr 11, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synapse Mental Health PLLCGroup PAC ID 6608344346, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Synapse Mental Health PLLC

  dba Synapse Collaborative

  • Clinical Psychologist
  • Carbondale, IL
  • NPI 1396638847
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1760915227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 E WALNUT ST",
            "address_2": "SUITE 1",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015002",
            "telephone_number": "618-351-9700",
            "fax_number": "618-351-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 E WALNUT ST",
            "address_2": "SUITE 1",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015002",
            "telephone_number": "618-351-9700",
            "fax_number": "618-351-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "KRISTIN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178012387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Girado, DC
• Girardo Chiropractic Center
• Amy Jo Glasco, FNP-BC
• Kenzie Lynn Glassburn, MD
• Erin Leigh Gleason
• Mary Jane Glisson Keller, ED.S., BCBA
• Jerry L Goddard, M.D.
• Wallace Adam Goforth, CRNA
• Bryan M Goldesberry, DMD
• Portia Goodin, MA, CCC-SLP

• Mental Health Counselor in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.