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Deactivated NPI 1447977624 Deactivated / Inactive NPI Male Practitioner

Cameron Michael Glick

Behavior Technician • Roslindale, MA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Cameron Glick has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 27, 2022
NPI Deactivation Date August 30, 2024
Total Practice Duration ~2 Years of Practice (2022 – 2024)

Professional Overview & Biography Verified Profile Summary

Cameron Glick was a registered Behavior Technician practicing in Roslindale, MA. Throughout an active medical career spanning 2 years, Cameron Glick provided care at the practice location at 780 AMERICAN LEGION HWY until profile deactivation on 2024-08-30.

Practice Location & Contact Primary Location

Practice Address

780 American Legion Hwy

Roslindale, MA 021313908

Telephone 6172673700
Associated Practice Facility / Clinic
🏢 The Home For Little Wanderers Facility NPI 1710045364

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Technician in Roslindale, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 3.9 Yrs
Regional Practice Density
8 Specialists

Practicing in Roslindale, MA (11487 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-16
Behavior Technician Primary Specialty

NUCC Taxonomy Code: 106S00000X

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Secondary Practice Locations

90 Canal St Fl 4

Boston, MA 021142018

Phone: 8889222843

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

39 Associated Practitioners
Puja Roth-Howe

Student in an Organized Health Care Education/Training Program

NPI 1013836717
Salome Ademan

Case Manager/Care Coordinator

NPI 1023876786
Thuan Le

Student in an Organized Health Care Education/Training Program

NPI 1043655624
Emily Knoepp

Student in an Organized Health Care Education/Training Program

NPI 1104436773
Lara Molfino

Counselor - Mental Health

NPI 1124770490
Joshua Neal

Student in an Organized Health Care Education/Training Program

NPI 1144906108

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location October 16, 2024

Registered at 780 AMERICAN LEGION HWY, ROSLINDALE, MA 021313908 (Tel: 6172673700)

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Updated Business Mailing Address October 16, 2024

Registered at 780 AMERICAN LEGION HWY, ROSLINDALE, MA 021313908 (Tel: 8889222843)

📍
Updated Practice Location September 10, 2024

Registered at 90 CANAL ST FL 4, BOSTON, MA 021142018 (Tel: 8889222843)

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Updated Business Mailing Address September 10, 2024

Registered at 90 CANAL ST FL 4, BOSTON, MA 021142018 (Tel: 8889222843)

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Provider Name / Credentials Updated September 10, 2024

Recorded as CAMERON GLICK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2024

Behavior Technician

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NPI Profile Deactivated August 30, 2024

Record deactivated on August 30, 2024

NPI Profile Active October 27, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location October 27, 2022

Registered at 90 CANAL ST FL 4, BOSTON, MA 021142018 (Tel: 8889222843)

📍
Updated Business Mailing Address October 27, 2022

Registered at 90 CANAL ST FL 4, BOSTON, MA 021142018 (Tel: 8889222843)

👤
Provider Name / Credentials Updated October 27, 2022

Recorded as CAMERON GLICK

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 27, 2022

Behavior Technician

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Initial NPI Registration & Enumeration October 27, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1447977624
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 27, 2022
Last Update: October 16, 2024
Deactivation Date: August 30, 2024
Sole Proprietor: No

Mailing Address

780 American Legion Hwy

Roslindale, MA 021313908

Phone: 8889222843

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.