Active NPI
Courtney Glinka
- Behavior Technician
- Grand Rapids, MI
National Provider Identifier
1881132744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- G 452 122 564 507
- Practice address
- 1149 Butterworth St SW
Grand Rapids, MI 49504 - Phone
- (810) 922-2610
- NPI assigned
- Feb 10, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | G 452 122 564 507 | MI | Primary |
Addresses
Primary practice location
1149 Butterworth St SW
Grand Rapids, MI 49504
Mailing address
1149 Butterworth St SW
Grand Rapids, MI 49504-6164
Phone (810) 922-2610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 730763 | Other | UNITED HEALTHCARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| G 452 122 564 507 | MI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486684800000",
"number": "1881132744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1149 BUTTERWORTH ST SW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495046164",
"telephone_number": "810-922-2610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1149 BUTTERWORTH ST SW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49504",
"telephone_number": "810-922-2610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLINKA",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-10",
"last_updated": "2017-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "G 452 122 564 507",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "730763",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.