Individual provider Active NPI

Jessica Lynn Glover, LMFT

  • Marriage & Family Therapist
  • Warner Robins, GA
National Provider Identifier
1871114918
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001675 Issued in GA
Practice address
96 Tommy Stalnaker Dr Ste B
Warner Robins, GA 31088-9236
Phone
(478) 333-2735
Fax
(478) 845-7390
NPI assigned
Apr 29, 2020
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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 MFT001675 GA Primary

Addresses

Primary practice location

96 Tommy Stalnaker Dr Ste B
Warner Robins, GA 31088-9236

Mailing address

96 Tommy Stalnaker Dr Ste B
Warner Robins, GA 31088-9236
Phone (478) 333-2735

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL encompasscounselingwellness Direct

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

State licenses

LicenseStateTypeSpecialty
MFT001675GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encompass Counseling, Wellness and Rehab CurrentSince May 3, 2020 Accepting new patients
New Connections Therapy, LLC Marriage & Family Therapist Current Accepting new patients

Locations

96 Tommy Stalnaker Dr
Ste B
Warner Robins, GA 31088
Phone (478) 333-2735

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1871114918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 TOMMY STALNAKER DR STE B",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889236",
            "telephone_number": "478-333-2735",
            "fax_number": "478-845-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 TOMMY STALNAKER DR STE B",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889236",
            "telephone_number": "478-333-2735",
            "fax_number": "478-845-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "encompasscounselingwellness",
            "affiliation": "N",
            "endpointDescription": "encompasscounselingwellness",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "business",
            "address_1": "96 Tommy Stalnaker Dr Ste B",
            "city": "Warner Robins",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310889236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.