Alexis Katherine Glidewell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW66532 Issued in CA

Practice address

2418 Hidden Valley Dr
Santa Rosa, CA 95404-2345

Phone

(707) 377-0080

NPI assigned

May 2, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Alexis Katherine Stone Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 29, 2024 through Dec 29, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1912696428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 B ST STE 1A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015269",
            "telephone_number": "707-377-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 HIDDEN VALLEY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954042345",
            "telephone_number": "707-377-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIDEWELL",
        "first_name": "ALEXIS",
        "middle_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW66532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "STONE",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Adams Gleason, DPT
• Diane C. Gleim, MA, LMFT
• Hayden Glenn
• William Glenn, MFT
• Andriya Glessner, RAS
• Global Fresh Start
• Sophie Glogovac-Smith
• Kayla Marie Gloisten, DC
• Corina M. Glover, MD
• Kyle Glover, MD

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.