Provider Demographics
NPI:1245549781
Name:GLYNN, MARTIN JOSEPH (LMHC)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:JOSEPH
Last Name:GLYNN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SUGAR HILL CIR
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-1836
Mailing Address - Country:US
Mailing Address - Phone:978-399-3170
Mailing Address - Fax:
Practice Address - Street 1:19 SUGAR HILL CIR
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-1836
Practice Address - Country:US
Practice Address - Phone:978-399-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health