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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

GLENN SAMPLE, PSY.D., PLLC
NPI 1962308718
Psychologist - Clinical in Rockford, IL

Active since October 19, 2026
7210 E STATE ST STE 102, ROCKFORD, IL 61108(773) 245-3449 Get Directions Write a Review

NPPES record added: October 19, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Glenn Sample, Psy.d., Pllc NPPES

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

GLENN SAMPLE, PSY.D., PLLC (NPI 1962308718) is a healthcare organization registered as a clinical in Rockford, Illinois and active in the NPI registry since October 2026. The organization lists Glenn Sample, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1962308718
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameGLENN SAMPLE, PSY.D., PLLC
Location Address7210 E STATE ST STE 102Rockford, IL 61108-2636
Mailing Address1643 N Alpine Rd # 104-609Rockford, IL 61107-1462 · (773) 245-3449
Phone(773) 245-3449
Organization SubpartNo
Authorized OfficialGlenn SampleClinical Psychologist · (773) 245-3449
Enumeration DateOctober 19, 2026
NPPES CertifiedOctober 18, 2026
✔ NPI 1962308718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
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.
7210 E STATE ST STE 102, Rockford, IL 61108
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Other Providers at the Same Location NPPES

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

STILLNESS AND BECOMING COUNSELING PLLC
Counselor (Professional)
7210 E STATE ST STE 102
ROCKFORD, IL 61108
Winnebago County (224) 650-6402

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 Sample, Psy.D., PLLC's NPI number?

The NPI number for Glenn Sample, Psy.D., PLLC is 1962308718. It was assigned to this organization in the NPPES registry on October 19, 2026.

Where is Glenn Sample, Psy.D., PLLC located?

Glenn Sample, Psy.D., PLLC is located at 7210 E State St Ste 102, Rockford, IL 61108. The listed phone number is (773) 245-3449.

What is Glenn Sample, Psy.D., PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Glenn Sample, Psy.D., PLLC was last updated on October 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.