Individual provider Active NPI

Susan F. Glaser, PH.D.

  • Clinical Psychologist
  • McLean, VA
National Provider Identifier
1144377789
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001124 Issued in VA
Practice address
1483 Chain Bridge Rd
Suite 304
McLean, VA 22101-5703
Phone
(703) 356-4044
Fax
(703) 883-0310
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810001124 VA Primary

Addresses

Primary practice location

1483 Chain Bridge Rd
Suite 304
McLean, VA 22101-5703

Mailing address

1483 Chain Bridge Rd
Suite 304
McLean, VA 22101-5703
Phone (703) 356-4044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810001124VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144377789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 CHAIN BRIDGE RD",
            "address_2": "SUITE 304",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221015703",
            "telephone_number": "703-356-4044",
            "fax_number": "703-883-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 CHAIN BRIDGE RD",
            "address_2": "SUITE 304",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221015703",
            "telephone_number": "703-356-4044",
            "fax_number": "703-883-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "SUSAN",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.