Active NPI
Glen William Cross, LMHC
- Mental Health Counselor
- Englewood, FL
National Provider Identifier
1780622860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC00104
- Practice address
- 7690 Castleberry Ter
Englewood, FL 34224-7882 - Phone
- (401) 450-6494
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC00104 | RI | Primary |
Addresses
Primary practice location
7690 Castleberry Ter
Englewood, FL 34224-7882
Mailing address
7690 Castleberry Ter
Englewood, FL 34224-7882
Phone (401) 450-6494
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104847946 | Other | RI | THE PROVIDENCE CENTER NPI |
| 407903 | Other | RI | BLUE CHIP |
| 62-40330 | Other | RI | UNITED BEHAVIORAL HEALTH |
| 30009-0 | Other | RI | BLUE CROSS |
| GC27077 | Medicaid | RI |
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 |
|---|---|---|---|
| MHC00104 | RI | MD | Mental Health Counselor |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1780622860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7690 CASTLEBERRY TER",
"city": "ENGLEWOOD",
"state": "FL",
"postal_code": "342247882",
"telephone_number": "401-450-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7690 CASTLEBERRY TER",
"city": "ENGLEWOOD",
"state": "FL",
"postal_code": "342247882",
"telephone_number": "401-450-6494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSS",
"first_name": "GLEN",
"middle_name": "WILLIAM",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2021-09-16",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "MHC00104",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE PROVIDENCE CENTER NPI",
"identifier": "1104847946",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "407903",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "62-40330",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "30009-0",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GC27077",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Englewood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.