Individual
MR. STEPHEN G. GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.M.
Contact information
Practice address
176 OLD FORGE XING, DEVON, PA 19333-1121
(610) 688-1138
Mailing address
176 OLD FORGE XING, DEVON, PA 19333-1121
(610) 688-1138
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS003422L
PA
103TC0700X
Clinical Psychologist
PS003422L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J90409
INTERCOUNY HEALTH PLAN
PA
Enumeration date
07/28/2006
Last updated
09/11/2025
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