Nikki J Glass, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0029590 Issued in OH

Practice address

822 Kumho Dr Ste 101
Fairlawn, OH 44333-9298

Phone

(330) 576-0126

Fax

(216) 649-0551

NPI assigned

Jul 20, 2021

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.nikkijeanglass@140094.advancedmd-direct.com

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.

• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1821661547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "216-468-5000",
            "fax_number": "216-456-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 KUMHO DR STE 101",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339298",
            "telephone_number": "330-576-0126",
            "fax_number": "216-649-0551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Cleveland Ave NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447021805",
            "country_code": "US",
            "telephone_number": "330-455-0374 x95252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3661 ARLINGTON RD STE D",
            "address_purpose": "LOCATION",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446856909",
            "country_code": "US",
            "telephone_number": "330-595-4628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 1st St NW",
            "address_purpose": "LOCATION",
            "city": "Massillon",
            "state": "OH",
            "postal_code": "446475452",
            "country_code": "US",
            "telephone_number": "330-833-0234",
            "fax_number": "330-837-7705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASS",
        "first_name": "NIKKI",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0029590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0459508",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Giebel
• Laura Gill
• Jennifer Celeste Gilliam, DC
• Lauren Gin, PT, DPT
• Linda M Ginesi, M.A.
• Autumn Nicole Glenn, BCBA
• Jonathan Gliebe
• Natika Goins
• Lisa Gojanovic, PCC
• Tara Goldstein, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.