Individual provider Active NPI

George P Glaser, M.S.W.

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1891797163
Registry record updated Aug 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00319 LCSW Issued in TX
Practice address
11005 Shady Hollow Dr
Austin, TX 78748-1819
Phone
(512) 371-9418
Fax
(512) 637-8889
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2024

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 00319 LCSW TX Primary

Addresses

Primary practice location

11005 Shady Hollow Dr
Austin, TX 78748-1819

Mailing address

11005 Shady Hollow Dr
Austin, TX 78748-1819
Phone (512) 371-9418

Other identifiers 2

IdentifierTypeStateIssuer
063867801MedicaidTX
54112070OtherTXBLUE CROSS BLUE SHIELD OF TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050202000580 TX Practitioner - Clinical Social Worker 5698726156 Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11005 Shady Hollow Dr
Austin, TX 78748-1819
Phone (512) 371-9418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00319 LCSWTXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724457600000",
    "number": "1891797163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11005 SHADY HOLLOW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787481819",
            "telephone_number": "512-371-9418",
            "fax_number": "512-637-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11005 SHADY HOLLOW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787481819",
            "telephone_number": "512-371-9418",
            "fax_number": "512-637-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "GEORGE",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "00319 LCSW",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063867801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "54112070",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.