Provider Demographics
NPI:1043090616
Name:E. GLYNN COUCH LCSW, PLLC
Entity Type:Organization
Organization Name:E. GLYNN COUCH LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:GLYNN
Authorized Official - Last Name:COUCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:716-783-4591
Mailing Address - Street 1:331 ALBERTA DR STE 104
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1813
Mailing Address - Country:US
Mailing Address - Phone:716-783-4591
Mailing Address - Fax:
Practice Address - Street 1:331 ALBERTA DR STE 104
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1813
Practice Address - Country:US
Practice Address - Phone:716-783-4591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty