Glenn Gordon Geralds, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P0000000072 Issued in TN

Practice address

1 Northgate Park
Suite 201
Chattanooga, TN 37415-6909

Phone

(423) 870-5647

Fax

(423) 870-5545

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912972738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NORTHGATE PARK",
            "address_2": "SUITE 201",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374156909",
            "telephone_number": "423-870-5647",
            "fax_number": "423-870-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NORTHGATE PARK",
            "address_2": "SUITE 201",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374156909",
            "telephone_number": "423-870-5647",
            "fax_number": "423-870-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERALDS",
        "first_name": "GLENN",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P0000000072",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.