Individual provider Active NPI

Matthew Vincent Glowiak, M.S., NCC, LPC

  • Mental Health Counselor
  • Naperville, IL
National Provider Identifier
1962823724
Registry record updated Dec 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.007268 Issued in IL
Practice address
616 W 5TH Ave
Suite B
Naperville, IL 60563-2914
Phone
(630) 717-7771
Fax
(630) 206-2003
NPI assigned
Dec 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.007268 IL Primary

Addresses

Primary practice location

616 W 5TH Ave
Suite B
Naperville, IL 60563-2914

Mailing address

616 W 5TH Ave
Suite B
Naperville, IL 60563-2914
Phone (630) 717-7771

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
178.007268ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1387584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387584000000",
    "number": "1962823724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W 5TH AVE",
            "address_2": "SUITE B",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632914",
            "telephone_number": "630-717-7771",
            "fax_number": "630-206-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W 5TH AVE",
            "address_2": "SUITE B",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632914",
            "telephone_number": "630-717-7771",
            "fax_number": "630-206-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOWIAK",
        "first_name": "MATTHEW",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "M.S., NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-21",
        "last_updated": "2013-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.007268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.