GLENN ANTHONY NILES JR. LPC
NPI 1477065720
Counselor - Professional in Grovetown, GA

Q: What is Glenn Niles's NPI number?

The NPI number for Glenn Niles is 1477065720. It was assigned to this individual provider in the NPPES registry on October 26, 2017.

Q: What is Glenn Niles's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Glenn Niles was last updated on February 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 26, 2017PECOS EnrolledAccepts Medicare Assignment

4039 GATEWAY BLVD, GROVETOWN, GA 30813(706) 498-9570(678) 369-5762 Get Directions Write a Review

NPPES record last updated: February 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 24, 2025, Apr 8, 2025, Oct 26, 2017 (3 updates tracked since 2017).

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About Glenn Anthony Niles Jr. Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLENN ANTHONY NILES JR. LPC (NPI 1477065720) is an individual professional provider in Grovetown, Georgia, licensed in Georgia (LPC009918) and active in the NPI registry since October 2017. He is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1477065720

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameGLENN ANTHONY NILES JR.Credential: LPC

Location Address4039 GATEWAY BLVDGrovetown, GA 30813-3389

Mailing Address4039 Gateway BlvdGrovetown, GA 30813-3389 · (706) 498-9570 · Fax (678) 369-5762

Phone(706) 498-9570

Fax(678) 369-5762

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateOctober 26, 2017

Last NPPES UpdateFebruary 20, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 20, 2026

✔ NPI 1477065720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in GA · LPC009918

4039 GATEWAY BLVD, Grovetown, GA 30813

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Glenn Anthony Niles Jr. Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749707362

PECOS Enrollment IDI20250507002365

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KARA CHRISTINE CURTIS D.P.T.

Physical Therapist

4039 GATEWAY BLVD, SUITE 102
GROVETOWN, GA 30813

Columbia County (706) 210-9534

DR. ROBERT A SUYKERBUYK MD

Family Medicine