Provider Demographics
NPI:1245211457
Name:GEIKIE, GLENDON MUIR SR (MSW)
Entity Type:Individual
Prefix:MR
First Name:GLENDON
Middle Name:MUIR
Last Name:GEIKIE
Suffix:SR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 TOWN FARM RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-1004
Mailing Address - Country:US
Mailing Address - Phone:978-874-9913
Mailing Address - Fax:978-874-9913
Practice Address - Street 1:16 WYMAN RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1601
Practice Address - Country:US
Practice Address - Phone:978-874-9913
Practice Address - Fax:978-874-9913
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1011361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO 1242Medicaid
MAPO 1242Medicare ID - Type Unspecified