Active NPI
Jette A Glazer, LCSW
- Social Worker
- North Conway, NH
National Provider Identifier
1962716381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MC12661
- Practice address
- 2757 White Mountain Highway
North Conway, NH 03860 - Phone
- (603) 733-6974
- NPI assigned
- Jul 27, 2010
- Last updated
- Feb 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MC12661 | ME | Primary |
| Clinical Social Worker | 1041C0700X | 1817 | NH |
Addresses
Primary practice location
2757 White Mountain Highway
North Conway, NH 03860
Mailing address
PO Box 1485
North Conway, NH 03860-1485
Phone (603) 733-6974
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC12661 | ME | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424649600000",
"number": "1962716381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1485",
"city": "NORTH CONWAY",
"state": "NH",
"postal_code": "038601485",
"telephone_number": "603-733-6974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2757 WHITE MOUNTAIN HIGHWAY",
"city": "NORTH CONWAY",
"state": "NH",
"postal_code": "03860",
"telephone_number": "603-733-6974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLAZER",
"first_name": "JETTE",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-27",
"last_updated": "2015-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "MC12661",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "1817",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Conway, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.