Individual provider Active NPI

Glen David Skoler, PH.D.

  • Clinical Psychologist
  • Lansdowne, PA
National Provider Identifier
1154652667
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
TPS030034 Issued in PA
Practice address
250 W Plumstead Ave
Lansdowne, PA 19050-1308
Phone
(240) 605-2988
Fax
(484) 461-9371
NPI assigned
Jan 22, 2010
Last updated
Jan 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X TPS030034 PA Primary
Clinical Psychologist 103TC0700X 02989 MD
Forensic Psychologist 103TF0200X TPS030034 PA
Forensic Psychologist 103TF0200X 02989 MD

Addresses

Primary practice location

250 W Plumstead Ave
Lansdowne, PA 19050-1308

Mailing address

250 W Plumstead Ave
Lansdowne, PA 19050-1308
Phone (240) 605-2988

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
02989MDMDForensic Psychologist
TPS030034PAMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1154652667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W PLUMSTEAD AVE",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190501308",
            "telephone_number": "240-605-2988",
            "fax_number": "484-461-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W PLUMSTEAD AVE",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190501308",
            "telephone_number": "240-605-2988",
            "fax_number": "484-461-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOLER",
        "first_name": "GLEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "TPS030034",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "02989",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "PA",
            "license": "TPS030034",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MD",
            "license": "02989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.