Kristen Nicole Glaeser, LCMHC-A. LCAS-A, NCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

28881 Issued in NC

Practice address

5755 Shattalon Dr
Winston Salem, NC 27105-1332

Phone

(336) 448-2628

NPI assigned

Aug 23, 2023

Last updated

Aug 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1922882638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2563 NC HIGHWAY 65",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273209311",
            "telephone_number": "336-552-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 SHATTALON DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271051332",
            "telephone_number": "336-448-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAESER",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "credential": "LCMHC-A. LCAS-A, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "1726249",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "28881",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18802",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent D Gitchel
• Give Grace Youth & Family Counseling, PLLC
• Davidson H. Givens, MD
• Laurence Bruce Givner, MD
• Laura Boyle Gladden, PA-C
• Antonia Glasco, LCAS, LCMHC, LCMHC-A
• Jasmine Monique Glascoe
• Cheryl S Glasgow, PA
• Alicia Glass
• Ashley Dawn Glass, DNP

• Addiction (Substance Use Disorder) Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.