Individual provider Active NPI

Julie Glazebrook, M.A., CCC/SLP

  • Speech-Language Pathologist
  • West Bloomfield, MI
National Provider Identifier
1992937809
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
6625 Daly Rd
West Bloomfield, MI 48322-3410
Phone
(248) 737-3430
Fax
(248) 737-3433
NPI assigned
Aug 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

6625 Daly Rd
West Bloomfield, MI 48322-3410

Mailing address

19193 Negaunee
Redford, MI 48240-1637
Phone (313) 610-8859

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 Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Kaufman Childrens Center for Speech Language Sensory Motor Soc Connect Speech-Language Pathologist PastSince Jan 4, 2016 Accepting new patients
Kaufman Children'S Center 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1992937809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19193 NEGAUNEE",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401637",
            "telephone_number": "313-610-8859",
            "fax_number": "248-737-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 DALY RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223410",
            "telephone_number": "248-737-3430",
            "fax_number": "248-737-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZEBROOK",
        "first_name": "JULIE",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.