Glen D King, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

137 Issued in AL

Practice address

1520 Mulberry St
Montgomery, AL 36106-1520

Phone

(334) 269-1106

Fax

(334) 832-9557

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinical and Forensic Psychologists, P.C.

  • Clinical Psychologist
  • Montgomery, AL
  • NPI 1245392091
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902968795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061520",
            "telephone_number": "334-269-1106",
            "fax_number": "334-832-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061520",
            "telephone_number": "334-269-1106",
            "fax_number": "334-832-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "GLEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AL",
            "license": "137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "70974KIN",
            "identifier": "70974KIN",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kinetic of Montgomery, LLC
• King Chiropractic Inc
• King Rehabilitation, LLC
• Carlton G. King, DMD
• Carolyn E King, P.T., M.S.
• Shelby Davis King, DMD
• Kingry Orthodontics, P.C.
• Gipson Mark Kingry, D.M.D.
• John Natravis Kinnion
• Jill Kinstler, PA

• Cognitive & Behavioral Psychologist in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Cognitive & Behavioral Psychologist in Alabama

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.