Glenn Phillip Hirsch, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP1068 Issued in MN

Practice address

2239 Carter Ave # 204
Saint Paul, MN 55108-1638

Phone

(612) 866-0955

Fax

(612) 624-0207

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Success Psychological Services PLLC

  • Adult Mental Health Clinic/Center
  • Saint Paul, MN
  • NPI 1184189714
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437207115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 E 26TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061730",
            "telephone_number": "612-866-0955",
            "fax_number": "612-624-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 CARTER AVE # 204",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081638",
            "telephone_number": "612-866-0955",
            "fax_number": "612-624-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH",
        "first_name": "GLENN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khristina R Hinnenkamp, LICSW
• Blaine E Hinrichs, RPH
• Patrick Scott Hinshon, CO
• Leroy M Hipp, D.D.S.
• Paul Thomas Hirdman, PH.D.
• Michael James Hirschel
• Anisa Farah Hirsi
• Khadro Hirsi
• Stephanie Hitchcock
• William Howard Hite Jr., D.D.S.

• Clinical Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Psychologist in Minnesota

• 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.