Active NPI
Glenn Keith Kreielsheimer, PH.D.
- Clinical Psychologist
- White Plains, NY
National Provider Identifier
1780898171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY008746
- Practice address
- 10 N Broadway Ste 1D
White Plains, NY 10601-2211 - Phone
- (914) 997-0447
- Fax
- (914) 997-7878
- NPI assigned
- May 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY008746 | NY | Primary |
Addresses
Primary practice location
10 N Broadway Ste 1D
White Plains, NY 10601-2211
Mailing address
10 N Broadway Ste 1D
White Plains, NY 10601-2211
Phone (914) 997-0447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 24, 2024 through Dec 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008746 | NY | MD | Mental Health Counselor |
| PSY008746 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780898171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 N BROADWAY STE 1D",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106012211",
"telephone_number": "914-997-0447",
"fax_number": "914-997-7878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 N BROADWAY STE 1D",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106012211",
"telephone_number": "914-997-0447",
"fax_number": "914-997-7878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREIELSHEIMER",
"first_name": "GLENN",
"middle_name": "KEITH",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "PSY008746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.