Glenn Richard Olds Jr., PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

34890 Issued in TX

Practice address

508 Deep Eddy Ave
Austin, TX 78703-4555

Phone

(512) 217-9579

Fax

(512) 469-0889

NPI assigned

Nov 9, 2011

Last updated

Nov 9, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deep Eddy Psychotherapy Management, LLC

  • Counseling Psychologist
  • Austin, TX
  • NPI 1457740862
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1033496799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 DEEP EDDY AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034555",
            "telephone_number": "512-217-9579",
            "fax_number": "512-469-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 DEEP EDDY AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034555",
            "telephone_number": "512-217-9579",
            "fax_number": "512-469-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDS",
        "first_name": "GLENN",
        "middle_name": "RICHARD",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "34890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Olarte-Hayes, LCSW
• Adepoju Olayemi
• Oluwabunmi Mary Olayinka, MD
• Kelly Ann Oldham-Senko
• Emilee Oldroyd, AMFT
• Victoria Olds, PH.D.
• Joseph Ramuta Oleary, ADULT NURSE PRACTITI
• Louis Olenick, ATP
• Ann Michelle Oler, MD, MPH
• Adam D Olesen, PHARMD

• Counseling Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.