Organization Active NPI

Felicia Glenn Gerrol, PH.D., Inc

  • Clinical Psychologist
  • Dover, NH
National Provider Identifier
1447772033
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011469 Issued in NY
Legal business name
FELICIA GLENN GERROL, PH.D., INC
Practice address
1 Rosemary Dr
Dover, NH 03820-2700
Phone
(518) 221-8518
Fax
(518) 453-2326
NPI assigned
Jul 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Ms. Felicia Glenn Gerrol, PH.D.NPI 1235227612
Title
Clinical Psychologist
Phone
(518) 221-8518

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 011469 NY Primary

Addresses

Primary practice location

1 Rosemary Dr
Dover, NH 03820-2700

Mailing address

1 Rosemary Dr
Dover, NH 03820-2700
Phone (518) 221-8518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231023000780 NH Part B Supplier - Clinic/Group Practice 2769723592 Receives reassigned benefits from 1 practitioner
Practice locations: Dover, NH

National Provider Directory

National Provider Directory

Locations

4 Atrium Dr
Ste 240
Albany, NY 12205
Phone (518) 453-9220

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1447772033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROSEMARY DR",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202700",
            "telephone_number": "518-221-8518",
            "fax_number": "518-453-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROSEMARY DR",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202700",
            "telephone_number": "518-221-8518",
            "fax_number": "518-453-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELICIA GLENN GERROL, PH.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "GERROL",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "518-221-8518",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.