Joel Nathan Glenn Wixson, PSYD CAS

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1056 Issued in NH

Practice address

539 Islington St
5
Portsmouth, NH 03801

Phone

(603) 427-6858

Fax

(603) 427-6555

NPI assigned

Nov 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174696413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 ISLINGTON ST",
            "address_2": "5",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-427-6858",
            "fax_number": "603-427-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 ISLINGTON ST",
            "address_2": "5",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-427-6858",
            "fax_number": "603-427-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN WIXSON",
        "first_name": "JOEL",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "PSYD CAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304ZO374",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "06Y00744INH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Gilligan, LCMHC
• Kara J Gilligan, APRN
• Paul James Giovannini
• Jonathan Saul Glass, MD
• Cayden McCrea Glenn Wixson
• Bobbie J Glidden, LICSW
• Milena Glynn, MS, MFT
• Sanjay Godara, MD
• Rachel M Godfred, MD
• Taylor Lynn Goguen

• Clinical Psychologist in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Clinical Psychologist in New Hampshire

• 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.
• 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.