| Travis Glass Counseling Pllc | |
|
352 2nd St Nw Ste 105 Hickory NC 28601-4954 | |
| (828) 781-0778 | |
| Not Available |
| Full Name | Travis Glass Counseling Pllc |
|---|---|
| Speciality | Counselor |
| Location | 352 2nd St Nw Ste 105, Hickory, North Carolina |
| Authorized Official Name and Position | Travis Shay Glass (OWNER) |
| Authorized Official Contact | 8287810778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Travis Glass Counseling Pllc 528 2nd St Nw Hickory NC 28601-4908 Ph: (828) 781-0778 | Travis Glass Counseling Pllc 352 2nd St Nw Ste 105 Hickory NC 28601-4954 Ph: (828) 781-0778 |
| NPI Number | 1124871306 |
|---|---|
| Provider Enumeration Date | 04/08/2024 |
| Last Update Date | 05/31/2024 |
| Certification Date | 05/31/2024 |
| Medicare PECOS PAC ID | 4880130822 |
|---|---|
| Medicare Enrollment ID | O20240725003056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124871306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Travis Shay Glass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932384542 PECOS PAC ID: 5799221735 Enrollment ID: I20240726001111 |
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