Glass House Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15935 Issued in AZ

Legal business name

GLASS HOUSE COUNSELING LLC

Practice address

4111 E Valley Auto Dr
Suite 201
Mesa, AZ 85206-4605

Phone

(480) 519-5256

NPI assigned

Jan 11, 2017

Last updated

Jan 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marisa MarvinNPI 1831633049

Title

Owner

Phone

(480) 519-5256

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marisa Marvin, LCSW

  • Clinical Social Worker
  • Mesa, AZ
  • NPI 1831633049
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1891231163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 E SIERRA MADRE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR",
            "address_2": "SUITE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064605",
            "telephone_number": "480-519-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASS HOUSE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-01-11",
        "status": "A",
        "authorized_official_last_name": "MARVIN",
        "authorized_official_first_name": "MARISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-519-5256"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "15935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "15935",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Giroux
• Heidi E Giroux, PT
• Saba Gische
• Bianca Giurgiu, LCSW
• Scott Eugene Glad, PT
• Keira Shae Glass Union
• Emily Marie Glass, COTA/L
• Samantha Christine Glasscock
• Vincent E. Glaub
• Melissa Glaus, PA-C

• Clinical Social Worker in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.