Provider Demographics
NPI:1912204686
Name:MEUNIER, GLENN M (LICSW)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:M
Last Name:MEUNIER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 N BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1148
Mailing Address - Country:US
Mailing Address - Phone:508-350-2450
Mailing Address - Fax:508-350-2319
Practice Address - Street 1:430 PLYMOUTH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HALIFAX
Practice Address - State:MA
Practice Address - Zip Code:02338-1342
Practice Address - Country:US
Practice Address - Phone:781-422-2900
Practice Address - Fax:781-422-2905
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115926101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor