Provider Demographics
NPI:1487688875
Name:GLYNN, MARCELL D (LCSW)
Entity Type:Individual
Prefix:
First Name:MARCELL
Middle Name:D
Last Name:GLYNN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 HIGHLAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4311
Mailing Address - Country:US
Mailing Address - Phone:832-858-1947
Mailing Address - Fax:281-980-8734
Practice Address - Street 1:2620 FOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 485
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7621
Practice Address - Country:US
Practice Address - Phone:713-244-0086
Practice Address - Fax:713-244-0059
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09042174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty