| Glenn Therapy, P.a. | |
|
285 Raymond Hill Rd Raymond ME 04071-6148 | |
| (207) 671-7804 | |
| Not Available |
| Full Name | Glenn Therapy, P.a. |
|---|---|
| Speciality | Counselor |
| Location | 285 Raymond Hill Rd, Raymond, Maine |
| Authorized Official Name and Position | Nichelle Gardner (OWNER/LCPC) |
| Authorized Official Contact | 2076717804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn Therapy, P.a. 285 Raymond Hill Rd Raymond ME 04071-6148 Ph: () - | Glenn Therapy, P.a. 285 Raymond Hill Rd Raymond ME 04071-6148 Ph: (207) 671-7804 |
| NPI Number | 1386498087 |
|---|---|
| Provider Enumeration Date | 04/17/2024 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Medicare PECOS PAC ID | 6507207826 |
|---|---|
| Medicare Enrollment ID | O20240516003049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386498087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Nichelle Gardner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336622208 PECOS PAC ID: 1850742305 Enrollment ID: I20240227004169 |
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