THOMAS MANCHESTER GLENNON PHD
NPI 1508972522
Psychologist - Clinical Child & Adolescent in Studio City, CA

Active since August 22, 2006PECOS EnrolledAccepts Medicare Assignment
12725 VENTURA BLVD, SUITE K, STUDIO CITY, CA 91604(818) 763-2745(818) 763-6876 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Thomas Manchester Glennon Phd NPPES

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

THOMAS MANCHESTER GLENNON PHD (NPI 1508972522) is an individual clinical child & adolescent provider in Studio City, California, licensed in California (PSY10326) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1986).

NPPES Registry Identity

NPI1508972522
Entity TypeIndividualMale
Primary Taxonomy103TC2200X
Provider Legal NameTHOMAS MANCHESTER GLENNONCredential: PHD
Location Address12725 VENTURA BLVD, SUITE KStudio City, CA 91604-2437
Mailing Address12725 Ventura Blvd, Suite KStudio City, CA 91604-2437 · (818) 763-2745 · Fax (818) 763-6876
Fax(818) 763-6876
Sole ProprietorYes
Medical School CMSOtherGraduated 1986
Enumeration DateAugust 22, 2006
Last NPPES UpdateSeptember 11, 2025
NPI 1508972522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers
Taxonomy Code103TC2200X
License Licensed in CA · PSY10326
Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Also ListedPsychologistTaxonomy 103T00000X · License PSY10326 (CA)
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PSY10326 (CA)
12725 VENTURA BLVD, Studio City, CA 91604

Accepted 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

Thomas Manchester Glennon Phd 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 ID7214911775
PECOS Enrollment IDI20040614001402
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.

Other Providers at the Same Location NPPES 3

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

Psychologist (Clinical)
12725 VENTURA BLVD, SUITE K
STUDIO CITY, CA 91604
Psychologist (Forensic)
12725 VENTURA BLVD, SUITE K
STUDIO CITY, CA 91604
Marriage & Family Therapist
12725 VENTURA BLVD, SUITE G
STUDIO CITY, CA 91604

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508972522, enumerated as an "individual" on August 22, 2006.

The provider is located at 12725 VENTURA BLVD SUITE K STUDIO CITY, CA 91604 and the phone number is (818) 763-2745.

Psychologist with taxonomy code 103TC2200X and a focus in Clinical Child & Adolescent.

The provider might be accepting Accepts: Providence Health Plan. Please consult your insurance carrier or call the provider to verify.