Individual provider Active NPI

Merille Campbell Glover, M.A., MFTI

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1780837658
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
INTERN REGISTRATION: Issued in CA
Practice address
4330 Auburn Blvd
Ste. 2200
Sacramento, CA 95841-4167
Phone
(916) 473-5764
Fax
(916) 473-5766
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X INTERN REGISTRATION: CA Primary

Addresses

Primary practice location

4330 Auburn Blvd
Ste. 2200
Sacramento, CA 95841-4167

Mailing address

4330 Auburn Blvd
Ste. 2200
Sacramento, CA 95841-4167
Phone (916) 473-5764

Other identifiers 1

IdentifierTypeStateIssuer
INTREN REG. # 43313OtherCACA BOARD OF BEHAVIORAL SCIENCES

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
INTERN REGISTRATION:CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1780837658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 AUBURN BLVD",
            "address_2": "STE. 2200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958414167",
            "telephone_number": "916-473-5764",
            "fax_number": "916-473-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 AUBURN BLVD",
            "address_2": "STE. 2200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958414167",
            "telephone_number": "916-473-5764",
            "fax_number": "916-473-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "MERILLE",
        "middle_name": "CAMPBELL",
        "name_prefix": "Ms.",
        "credential": "M.A., MFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "INTERN REGISTRATION:",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "INTREN REG. # 43313",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.