Active NPI
Jann Glider, PH.D.
- Clinical Child & Adolescent Psychologist
- Philadelphia, PA
National Provider Identifier
1386042679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PS 004336-L
- Practice address
- 6811 Quincy St
Philadelphia, PA 19119-2663 - Phone
- (215) 514-2130
- NPI assigned
- Dec 18, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS 004336-L | PA | Primary |
Addresses
Primary practice location
6811 Quincy St
Philadelphia, PA 19119-2663
Mailing address
514 E Lancaster Ave Apt C1
Wynnewood, PA 19096-2348
Phone (215) 514-2130
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS 004336-L | PA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418860800000",
"number": "1386042679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 E LANCASTER AVE APT C1",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190962348",
"telephone_number": "215-514-2130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6811 QUINCY ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191192663",
"telephone_number": "215-514-2130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLIDER",
"first_name": "JANN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-18",
"last_updated": "2014-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS 004336-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.