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DR. GLEN ALLEN CHILSTROM PH.D.
NPI 1326027293
Psychologist - Clinical in Alexandria, VA

Active since January 10, 2006PECOS EnrolledAccepts Medicare Assignment
109 S FAIRFAX ST, ALEXANDRIA, VA 22314(703) 765-6085 Get Directions Write a Review

NPPES record last updated: February 7, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Glen Allen Chilstrom Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLEN ALLEN CHILSTROM PH.D. (NPI 1326027293) is an individual clinical provider in Alexandria, Virginia, licensed in Virginia (0810001353) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1326027293
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. GLEN ALLEN CHILSTROMCredential: PH.D.
Location Address109 S FAIRFAX STAlexandria, VA 22314-3301
Mailing Address1136 Westmoreland RdAlexandria, VA 22308-1245 · (703) 765-6085
Phone(703) 765-6085
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateJanuary 10, 2006
Last NPPES UpdateFebruary 7, 2012
✔ NPI 1326027293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in VA · 0810001353
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
109 S FAIRFAX ST, Alexandria, VA 22314
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Other Identifiers 2

Medicaid7701691VA
Medicare ID-Type Unspecified490709VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Glen Allen Chilstrom Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830387745
PECOS Enrollment IDI20101220000364
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
181 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22314 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$194.86 typical visit price
range $65.18 – $194.86
Typical copayment $48.71 (range $16.29 – $48.71)
Most-billed visit code 99205
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KATHRYN FORD PATRIZIA M.S.W.
Social Worker (Clinical)
109 S FAIRFAX ST, SECOND FLOOR
ALEXANDRIA, VA 22314
Alexandria City (704) 684-7882

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Chilstrom's NPI number?

The NPI number for Glen Chilstrom is 1326027293. It was assigned to this individual provider in the NPPES registry on January 10, 2006.

Where is Glen Chilstrom located?

Glen Chilstrom practices at 109 S Fairfax St, Alexandria, VA 22314. The listed phone number is (703) 765-6085.

What is Glen Chilstrom's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Glen Chilstrom enrolled in Medicare?

Yes. Glen Chilstrom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Glen Chilstrom accept?

Health plans from Providence Health Plan list Glen Chilstrom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glen Chilstrom was last updated on February 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.