Provider Demographics
NPI:1427593144
Name:EMILY ELIZABETH GLOD
Entity Type:Organization
Organization Name:EMILY ELIZABETH GLOD
Other - Org Name:EMILY GLOD, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:E
Authorized Official - Last Name:GLOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-509-1928
Mailing Address - Street 1:6 THORNDAL CIR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5415
Mailing Address - Country:US
Mailing Address - Phone:917-509-1928
Mailing Address - Fax:
Practice Address - Street 1:6 THORNDAL CIR
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5415
Practice Address - Country:US
Practice Address - Phone:917-509-1928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT95541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty