DR. STEFANIE GLENNON
NPI 1700455607
Psychologist - Clinical in New York, NY

Q: What is Stefanie Glennon's NPI number?

The NPI number for Stefanie Glennon is 1700455607. It was assigned to this individual provider in the NPPES registry on June 23, 2021.

Q: What is Stefanie Glennon's specialty?

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

Q: Is Stefanie Glennon enrolled in Medicare?

No. Stefanie Glennon has opted out of Medicare through August 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Stefanie Glennon was last updated on June 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 23, 2021Opted out of Medicare · through Aug 5, 2028

12 W 72ND ST APT 4E, NEW YORK, NY 10023(917) 533-0558(212) 496-0369 Get Directions Write a Review

NPPES record last updated: June 23, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Dr. Stefanie Glennon NPPES

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

DR. STEFANIE GLENNON (NPI 1700455607) is an individual clinical provider in New York, New York, licensed in New York (007762-1) and active in the NPI registry since June 2021. She has opted out of Medicare through August 5, 2028.

NPPES Registry Identity

NPI1700455607

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. STEFANIE GLENNON

Location Address12 W 72ND ST APT 4ENew York, NY 10023-4164

Mailing Address12 W 72nd St Apt 4eNew York, NY 10023-4164

Phone(917) 533-0558

Fax(212) 496-0369

Sole ProprietorYes

Enumeration DateJune 23, 2021

NPPES CertifiedJune 23, 2021

✔ NPI 1700455607 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 NY · 007762-1

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.

12 W 72ND ST APT 4E, New York, NY 10023

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Stefanie Glennon has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 5, 2016 through August 5, 2028.

Opt-Out Effective DateAugust 5, 2016

Opt-Out In Effect ThroughAugust 5, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Stefanie Glennon's NPI number?

The NPI number for Stefanie Glennon is 1700455607. It was assigned to this individual provider in the NPPES registry on June 23, 2021.

Where is Stefanie Glennon located?

Stefanie Glennon practices at 12 W 72nd St Apt 4E, New York, NY 10023. The listed phone number is (917) 533-0558.

What is Stefanie Glennon's specialty?

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

Is Stefanie Glennon enrolled in Medicare?

No. Stefanie Glennon has opted out of Medicare through August 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Stefanie Glennon was last updated on June 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.