Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104993153 Individual Practitioner Male Practitioner

Dr. Glen Owen Sallows , PhD, BCBA-D

Psychologist • Madison, WI

Professional Overview & Biography Verified Profile Summary

Dr. Glen Sallows, PhD, BCBA-D is a registered healthcare professional specializing in Psychologist in Madison, WI. Practice services are available at 1210 FOURIER DRIVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1210 Fourier Drive
Suite #100

Madison, WI 537171969

Telephone 6086629327
Fax 6086629041
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Madison, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.5 Yrs
State Avg: 22.4 Yrs
Regional Practice Density
216 Specialists

Practicing in Madison, WI (1000 Statewide)

Telehealth Adoption Rate
23.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License WI 823057

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Behavior Analyst

NUCC Taxonomy Code: 103K00000X

State License WI 54-140

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1104993153 (WI)
Medicaid State Provider ID
39020200 (WI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Jodie Garcia , LCSW

Social Worker

NPI 1013297787

Licensed Clinical Social Worker

Dr. Joseph Perron , PhD, BCBA-D

Psychologist - Clinical

NPI 1063525079

Doctor of Philosophy (Ph.D.), Board Certified Behavior Analyst - Doctoral

NPI 1104176387

Master of Science, Bachelor of Arts, Board Certified Behavior Analyst

NPI 1134502651

Board Certified Behavior Analyst

Erin Junemann , BCBA

Behavior Analyst

NPI 1144603655

Board Certified Behavior Analyst

Emily Martin , MS, OTR

Occupational Therapist

NPI 1164859054

Master of Science, Occupational Therapist Registered

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 17, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location November 17, 2015

Registered at 1210 FOURIER DRIVE, SUITE #100, MADISON, WI 537171969 (Tel: 6086629327)

📍
Updated Business Mailing Address November 17, 2015

Registered at 1210 FOURIER DRIVE, SUITE #100, MADISON, WI 537171969 (Tel: 6086629327)

👤
Provider Name / Credentials Updated November 17, 2015

Recorded as GLEN SALLOWS, PHD, BCBA-D

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 17, 2015

Psychologist (License #823057 in WI)

🟢
Initial NPI Registration & Enumeration November 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104993153
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 28, 2006
Last Update: November 17, 2015
Sole Proprietor: No

Mailing Address

1210 Fourier Drive, Suite #100

Madison, WI 537171969

Phone: 6086629327

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.