Active NPI
Glenn Noel Paule-Carres, PH.D.
- Psychologist
- Winchester, VA
National Provider Identifier
1871503631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0810001007
- Practice address
- 124 Amherst St
Winchester, VA 22601-4114 - Phone
- (540) 667-0461
- Fax
- (540) 662-6334
- NPI assigned
- Aug 8, 2006
- 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 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810001007 | VA | Primary |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 0810001007 | VA | |
| Adult Development & Aging Psychologist | 103TA0700X | 0810001007 | VA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 0810001007 | VA | |
| Clinical Psychologist | 103TC0700X | 0810001007 | VA | |
| Counseling Psychologist | 103TC1900X | 0810001007 | VA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 0810001007 | VA | |
| Family Psychologist | 103TF0000X | 0810001007 | VA | |
| Health Service Psychologist | 103TH0100X | 0810001007 | VA | |
| Group Psychotherapy Psychologist | 103TP2701X | 0810001007 | VA | |
| Marriage & Family Therapist | 106H00000X | 0810001007 | VA |
Addresses
Primary practice location
124 Amherst St
Winchester, VA 22601-4114
Mailing address
PO Box 82
Winchester, VA 22604-0082
Phone (540) 667-0461
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 067059 | Other | BLUE SHIELD | |
| 225634 | Other | ALLIANCE | |
| 029294000 | Other | MAGELLAN | |
| 007716397 | Medicaid | VA | |
| 088373 | Other | SENTARA | |
| 541201531 | Other | TRICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0810001007 | VA | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222992000000",
"number": "1871503631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 82",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226040082",
"telephone_number": "540-667-0461",
"fax_number": "540-662-6334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 AMHERST ST",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226014114",
"telephone_number": "540-667-0461",
"fax_number": "540-662-6334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULE-CARRES",
"first_name": "GLENN",
"middle_name": "NOEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2008-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810001007",
"primary": true
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "VA",
"license": "0810001007",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "VA",
"license": "0810001007",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "067059",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE",
"identifier": "225634",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "029294000",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007716397",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "088373",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "541201531",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.