Individual provider Active NPI

Connie Marie Glasco, LPC

  • Counselor
  • Heavener, OK
National Provider Identifier
1790905107
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
599 Issued in OK
Practice address
501 East 2ND St
Heavener, OK 74937
Phone
(918) 653-7718
Fax
(918) 653-7279
NPI assigned
Apr 26, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 599 OK Primary
Mental Health Counselor 101YM0800X 599 OK

Addresses

Primary practice location

501 East 2ND St
Heavener, OK 74937

Mailing address

40479 Morris Creek Rd
Howe, OK 74940-7364
Phone (918) 658-3891

Other identifiers 1

IdentifierTypeStateIssuer
599OtherOKLPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
599OKMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1790905107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40479 MORRIS CREEK RD",
            "city": "HOWE",
            "state": "OK",
            "postal_code": "749407364",
            "telephone_number": "918-658-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 EAST 2ND ST",
            "city": "HEAVENER",
            "state": "OK",
            "postal_code": "74937",
            "telephone_number": "918-653-7718",
            "fax_number": "918-653-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASCO",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "599",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "599",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Heavener, OK

Sources for this page

Verify at the official NPI Registry.