Kyle Alan Glasgow, PSYD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301012482 Issued in MI

Practice address

26105 Orchard Lake Rd
Ste 204
Farmington Hills, MI 48334-4576

Phone

(313) 296-1779

Fax

(248) 957-8544

NPI assigned

Sep 3, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Betz King PCGroup PAC ID 7315099405, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Betz King PC

  • Clinical Psychologist
  • Farmington Hills, MI
  • NPI 1538303474
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440806400000",
    "number": "1114175148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26105 ORCHARD LAKE RD",
            "address_2": "STE 204",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344576",
            "telephone_number": "313-296-1779",
            "fax_number": "248-957-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26105 ORCHARD LAKE RD",
            "address_2": "STE 204",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344576",
            "telephone_number": "313-296-1779",
            "fax_number": "248-957-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASGOW",
        "first_name": "KYLE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2015-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012482",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MI",
            "license": "6301012482",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Glaize, RBT
• Charis Glanville
• Emma Glanville
• Demarlo Glasco
• Ariana Glascoe
• Trinity Glason
• Veronica Glaspie
• Chae Glass
• Don Glass
• Haley Glass

• Psychologist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.