Individual provider Active NPI

Glenda Lee Reid, LCSW

  • Clinical Social Worker
  • Glendora, CA
National Provider Identifier
1831381763
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS15997 Issued in CA
Practice address
150 E Meda Ave
Suite 110
Glendora, CA 91741-2689
Phone
(626) 705-2540
Fax
(626) 963-8320
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS15997 CA Primary

Addresses

Primary practice location

150 E Meda Ave
Suite 110
Glendora, CA 91741-2689

Mailing address

PO Box 1453
Glendora, CA 91740-1453
Phone (626) 705-2540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20071127000202 CA Practitioner - Clinical Social Worker 7911095088 Practice locations: Glendora, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS15997CAMDClinical Social Worker
15997CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry Professional Services Inc PastSince Jan 12, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1831381763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1453",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917401453",
            "telephone_number": "626-705-2540",
            "fax_number": "626-963-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E MEDA AVE",
            "address_2": "SUITE 110",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412689",
            "telephone_number": "626-705-2540",
            "fax_number": "626-963-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "GLENDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS15997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.