Healthcare Provider Details

I. General information

NPI: 1932063823
Provider Name (Legal Business Name): GLIMMER COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PLEASANT ST UNIT 39
NOBLESVILLE IN
46060-3624
US

IV. Provider business mailing address

1900 PLEASANT ST UNIT 39
NOBLESVILLE IN
46060-3624
US

V. Phone/Fax

Practice location:
  • Phone: 317-537-1484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAYLER KOSTECKA
Title or Position: OWNER
Credential:
Phone: 317-966-2405