Individual provider Active NPI

Steven B. Glazier, MA

  • Clinical Psychologist
  • Bala Cynwyd, PA
National Provider Identifier
1548304330
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS005789L Issued in PA
Practice address
201 N Presidential Blvd
Suite 201
Bala Cynwyd, PA 19004-1257
Phone
(215) 782-3160
Fax
(215) 782-3161
NPI assigned
Feb 16, 2007
Last updated
Sep 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS005789L PA
Clinical Psychologist 103TC0700X PS005789L PA Primary

Addresses

Primary practice location

201 N Presidential Blvd
Suite 201
Bala Cynwyd, PA 19004-1257

Mailing address

201 N Presidential Blvd
Suite 201
Bala Cynwyd, PA 19004-1257
Phone (215) 782-3160

Other identifiers 1

IdentifierTypeStateIssuer
0015336200004MedicaidPA

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
PS005789LPAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1548304330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N PRESIDENTIAL BLVD",
            "address_2": "SUITE 201",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041257",
            "telephone_number": "215-782-3160",
            "fax_number": "215-782-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N PRESIDENTIAL BLVD",
            "address_2": "SUITE 201",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041257",
            "telephone_number": "215-782-3160",
            "fax_number": "215-782-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZIER",
        "first_name": "STEVEN",
        "middle_name": "B.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS005789L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS005789L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015336200004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.