Individual provider Active NPI

Glenn Phillip Horwitz, PH.D.

  • Clinical Psychologist
  • Fairfax, VA
National Provider Identifier
1437335734
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810003784 Issued in VA
Practice address
9518C Lee Hwy
Fairfax, VA 22031
Phone
(571) 438-2992
NPI assigned
Jan 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 0810003784 VA
Forensic Psychologist 103TF0200X 0810003784 VA
Psychoanalysis Psychologist 103TP0814X 0810003784 VA
School Psychologist 103TS0200X 0810003784 VA
Clinical Psychologist 103TC0700X 0810003784 VA Primary

Addresses

Primary practice location

9518C Lee Hwy
Fairfax, VA 22031

Mailing address

9518C Lee Hwy
Fairfax, VA 22031-2303
Phone (571) 438-2992

Other practice location 1

9518C Lee Hwy
Fairfax, VA 22031
Phone (571) 438-2992

Other practice location 2

18235 Foundry Rd
Purcellville, VA 20132-4077
Phone (571) 438-2992

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810003784VAMDClinical Child & Adolescent Psychologist
18423CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1437335734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9518C LEE HWY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312303",
            "telephone_number": "571-438-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9518C LEE HWY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "571-438-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9518C Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "22031",
            "country_code": "US",
            "telephone_number": "571-438-2992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18235 Foundry Rd",
            "address_purpose": "LOCATION",
            "city": "Purcellville",
            "state": "VA",
            "postal_code": "201324077",
            "country_code": "US",
            "telephone_number": "571-438-2992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORWITZ",
        "first_name": "GLENN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-16",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810003784",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "VA",
            "license": "0810003784",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "VA",
            "license": "0810003784",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "VA",
            "license": "0810003784",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.