Healthcare Provider Details

I. General information

NPI: 1952276388
Provider Name (Legal Business Name): EMILY GLENNON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CORDWAINER DR
NORWELL MA
02061-1671
US

IV. Provider business mailing address

200 CORDWAINER DR
NORWELL MA
02061-1671
US

V. Phone/Fax

Practice location:
  • Phone: 781-878-8340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1720221740
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: