Active NPI
Stephanie Louise Glass
- Behavior Technician
- Odessa, FL
National Provider Identifier
1992212047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 16414 Lake Church Dr
Odessa, FL 33556-2637 - Phone
- (813) 926-5454
- NPI assigned
- Jan 10, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Primary |
Addresses
Primary practice location
16414 Lake Church Dr
Odessa, FL 33556-2637
Mailing address
5950 W Poplar Springs Cir
Crystal River, FL 34429-2722
Phone (352) 422-1590
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515542400000",
"number": "1992212047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5950 W POPLAR SPRINGS CIR",
"city": "CRYSTAL RIVER",
"state": "FL",
"postal_code": "344292722",
"telephone_number": "352-422-1590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16414 LAKE CHURCH DR",
"city": "ODESSA",
"state": "FL",
"postal_code": "335562637",
"telephone_number": "813-926-5454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "STEPHANIE",
"middle_name": "LOUISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-10",
"last_updated": "2018-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.