Provider Demographics
NPI:1093506081
Name:GLYNN CONSULTING & CLINICAL SERVICES LLC
Entity type:Organization
Organization Name:GLYNN CONSULTING & CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-297-7242
Mailing Address - Street 1:218 HANOVER ST # 130030
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113-2302
Mailing Address - Country:US
Mailing Address - Phone:671-297-7242
Mailing Address - Fax:
Practice Address - Street 1:218 HANOVER ST # 130030
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-2302
Practice Address - Country:US
Practice Address - Phone:671-297-7242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty