Lydia S Glass PHD Psychological & Mediation Services Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PSY13464 Issued in CA

Legal business name

LYDIA S GLASS PHD PSYCHOLOGICAL & MEDIATION SERVICES INC

Practice address

200 E del Mar Blvd Ste 210
Pasadena, CA 91105-2551

Phone

(626) 792-4153

Fax

(626) 930-0626

NPI assigned

Apr 16, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Lydia S GlassNPI 1518179035

Title

President

Phone

(626) 792-4153

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lydia S. Glass, PH.D.

  • Mental Health Counselor
  • Pasadena, CA
  • NPI 1518179035
  Medicare reassignment Authorized official
• Douglas Bear, CMT

  • Massage Therapist
  • Pasadena, CA
  • NPI 1912789777
  NPD
• Holly Leigh Edge-Booth, PH.D.

  • Clinical Neuropsychologist
  • Pasadena, CA
  • NPI 1144393778
  NPD (past)

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1861635013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E DEL MAR BLVD STE 210",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052551",
            "telephone_number": "626-792-4153",
            "fax_number": "626-930-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E DEL MAR BLVD STE 210",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052551",
            "telephone_number": "626-792-4153",
            "fax_number": "626-930-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIA S GLASS PHD PSYCHOLOGICAL & MEDIATION SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-792-4153",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSY13464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CP13464",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Ly
• Linna Ly, PHARMD
• Luong T Ly, MD
• Michael Ly, D.M.D
• Vivian Chau Ly
• Keonee N Lyles, LVN
• Natalie Margaret Lyles
• Julia Susan Lynch
• Kathleen Lynch
• Rashaun S Lynch

• Mental Health Counselor in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.