Philip Adrian Glickman, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021281 Issued in NY

Practice address

140 Broadway # 4657
New York, NY 10005-1108

Phone

(646) 961-4973

NPI assigned

Jul 8, 2011

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Practice roles

Locations

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.

• Wellness Road Psychology, PLLC

  • Clinical Psychologist
  • New York, NY
  • NPI 1639709439
  NPD Authorized official
• Wellness Way Psychology PLLC

  • Psychologist
  • New York, NY
  • NPI 1407699416
  NPD Authorized official

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1942597166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 BOERUM PL",
            "address_2": "6G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112017713",
            "telephone_number": "914-671-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BROADWAY # 4657",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100051108",
            "telephone_number": "646-961-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "PHILIP",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Glickman, M.D.
• Michael S Glickman, MD
• Myles Glickman
• Paula Louise Glickman, LCSW
• Peter Louis Glickman, M.D.
• Robert M. Glickman, M.D.
• Samantha Ally Glickman
• Stephanie Glickman, MSW
• Alison Glicksman Holden, MSED,TVI
• Roslynn S Glicksman, M.D.

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.