Individual provider Active NPI

Michael Glaz, MS, CASAC-T

  • Counselor
  • Brooklyn, NY
National Provider Identifier
1972882447
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
25563 Issued in NY
Practice address
255 Avenue W
Brooklyn, NY 11223-5202
Phone
(866) 569-7233
Fax
(718) 336-6815
NPI assigned
Aug 15, 2011
Last updated
Aug 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 25563 NY Primary

Addresses

Primary practice location

255 Avenue W
Brooklyn, NY 11223-5202

Mailing address

PO Box 230060
Brooklyn, NY 11223-0060
Phone (866) 569-7233

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
25563NYMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Foundation Past Accepting new patients
The Safe Foundation, Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1972882447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230060",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112230060",
            "telephone_number": "866-569-7233",
            "fax_number": "718-336-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 AVENUE W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235202",
            "telephone_number": "866-569-7233",
            "fax_number": "718-336-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZ",
        "first_name": "MICHAEL",
        "credential": "MS, CASAC-T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "25563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.