Active NPI
Melinda H. Glass, PH.D.
- Clinical Psychologist
- Palmer, AK
National Provider Identifier
1932232022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 440
- Practice address
- 642 S Alaska St
Suite 219
Palmer, AK 99645-6342 - Phone
- (907) 746-7306
- NPI assigned
- Mar 14, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | 440 | AK | Primary |
Addresses
Primary practice location
642 S Alaska St
Suite 219
Palmer, AK 99645-6342
Mailing address
PO Box 3517
Palmer, AK 99645
Phone (907) 746-7306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2020 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932232022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3517",
"city": "PALMER",
"state": "AK",
"postal_code": "99645",
"telephone_number": "907-746-7306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "642 S ALASKA ST",
"address_2": "SUITE 219",
"city": "PALMER",
"state": "AK",
"postal_code": "996456342",
"telephone_number": "907-746-7306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "MELINDA",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AK",
"license": "440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmer, AK
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.