Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Glenn Anthony Niles Jr., LPC

Individual provider Professional Counselor · NPI 1477065720

Glenn Anthony Niles Jr., LPC is a Mental Health Counselor in Grovetown, Georgia. Qualified in 1999, 27 years ago. Practices with Personal Recovery Network LLC, a 605-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
27
Licensed in
GA
In the registry since
2017
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

4039 Gateway Blvd
Grovetown, GA 30813-3389
Phone: (706) 498-9570
Fax: (678) 369-5762
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC009918 (GA)

Record details

NPI number1477065720
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorNo
NPI enumeratedOctober 26, 2017
Last updated in NPPESFebruary 20, 2026
Certification dateFebruary 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Personal Recovery Network Llc — 605 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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