Active NPI
Cynthia Glines, PSY.D.
- Clinical Psychologist
- Tacoma, WA
National Provider Identifier
1679730881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20927
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-0001 - Phone
- (253) 968-5371
- NPI assigned
- May 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1022 | ID | |
| Clinical Psychologist | 103TC0700X | 015889 | NY | |
| Clinical Psychologist | 103TC0700X | 20927 | CA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-0001
Mailing address
PO Box 104
Gig Harbor, WA 98335-0104
Phone (253) 968-5371
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1022 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574035200000",
"number": "1679730881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 104",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983350104",
"telephone_number": "253-968-5371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-5371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLINES",
"first_name": "CYNTHIA",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-16",
"last_updated": "2019-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "1022",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "015889",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "20927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.