Provider Demographics
NPI:1275003881
Name:JAMES A. R. GLYNN, PSY.D., LLC
Entity Type:Organization
Organization Name:JAMES A. R. GLYNN, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ASHLEY ROBIN
Authorized Official - Last Name:GLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:862-261-2121
Mailing Address - Street 1:39 RAINBOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1126
Mailing Address - Country:US
Mailing Address - Phone:201-704-5428
Mailing Address - Fax:201-565-0590
Practice Address - Street 1:39 RAINBOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1126
Practice Address - Country:US
Practice Address - Phone:201-704-5428
Practice Address - Fax:201-565-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0563803Medicaid