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Dr. Glenn Sample, PSYD
Clinical Psychologist in Rockford, Illinois
NPI 1881915270

Glenn Sample is a Clinical Psychologist based in Rockford, IL and is specialized in Clinical. Glenn Sample practices in Rockford, IL and has the professional credentials of PSYD. The NPI Number for Glenn Sample is 1881915270 and holds a License No. 178010086 (Illinois).

The current practice location address for Glenn Sample is 1643 N Alpine Rd Ste 104-609, Rockford, IL and can be reached out via phone at 773-245-3449.

Location: 1643 N Alpine Rd Ste 104-609, Rockford, IL, 61107-1462
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1881915270
Provider Name
Glenn Sample
Credential
PSYD
Provider Entity Type
Individual
Gender
Male
Address
1643 N Alpine Rd Ste 104-609, Rockford, IL, 61107-1462
Phone Number
773-245-3449
Fax Number
Provider Enumeration Date
06/20/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1643 N Alpine Rd Ste 104-609
City
Rockford
State
Illinois
Zip
61107-1462
Phone Number
773-245-3449
Fax Number
person
Provider Business Mailing Address Details
Address
1643 N Alpine Rd Ste 104-609
City
Rockford
State
Illinois
Zip
61107-1462
Phone Number
773-245-3449
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
180010078 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
178010086 (Illinois)
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.
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