DR. GLENN DAVID TANITA D.M.H.
NPI 1669632006
Psychologist in Sierra Vista, AZ

Active since June 10, 2008PECOS EnrolledAccepts Medicare Assignment
77 CALLE PORTAL STE C240, SIERRA VISTA, AZ 85635(520) 459-3011 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Glenn David Tanita D.m.h. NPPES

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

DR. GLENN DAVID TANITA D.M.H. (NPI 1669632006) is an individual psychologist in Sierra Vista, Arizona, licensed in Arizona (1249) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1669632006
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. GLENN DAVID TANITACredential: D.M.H.
Location Address77 CALLE PORTAL STE C240Sierra Vista, AZ 85635-2986
Mailing Address1205 N F AveDouglas, AZ 85607-1920 · (520) 459-3110
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateJune 10, 2008
Last NPPES UpdateFebruary 20, 2024
NPPES CertifiedFebruary 20, 2024
NPI 1669632006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in AZ · 1249 Licensed in AZ · PSY-001249
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
77 CALLE PORTAL STE C240, Sierra Vista, AZ 85635

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

Dr. Glenn David Tanita D.m.h. 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 ID6002705977
PECOS Enrollment IDI20211124001606
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 7

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

Social Worker (Clinical)
77 CALLE PORTAL STE C240
SIERRA VISTA, AZ 85635
Clinic/Center (Federally Qualified Health Center (FQHC))
77 CALLE PORTAL STE C240
SIERRA VISTA, AZ 85635
Nurse Practitioner (Psychiatric/Mental Health)
77 CALLE PORTAL STE C240
SIERRA VISTA, AZ 85635
Social Worker (Clinical)
77 CALLE PORTAL STE C240
SIERRA VISTA, AZ 85635
Nurse Practitioner (Psychiatric/Mental Health)
77 CALLE PORTAL STE C240
SIERRA VISTA, AZ 85635
Counselor (Professional)
77 CALLE PORTAL STE C240
SIERRA VISTA, AZ 85635
Social Worker (Clinical)
77 CALLE PORTAL STE C240
SIERRA VISTA, AZ 85635

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 Glenn Tanita's NPI number?

The NPI number for Glenn Tanita is 1669632006. It was assigned to this individual provider in the NPPES registry on June 10, 2008.

Where is Glenn Tanita located?

Glenn Tanita practices at 77 Calle Portal Ste C240, Sierra Vista, AZ 85635. The listed phone number is (520) 459-3011.

What is Glenn Tanita's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Glenn Tanita enrolled in Medicare?

Yes. Glenn Tanita 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 Glenn Tanita accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list Glenn Tanita 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 Glenn Tanita was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.