Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Glen Allen Chilstrom, PHD

Individual provider Clinical Psychologist · NPI 1326027293

Dr. Glen Allen Chilstrom, PHD is a Clinical Psychologist in Alexandria, Virginia. Qualified in 1985, 41 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
41
Licensed in
VA
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

109 S Fairfax St
Alexandria, VA 22314-3301
Phone: (703) 765-6085
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 0810001353 (VA)

Record details

NPI number1326027293
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedJanuary 10, 2006
Last updated in NPPESFebruary 7, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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