Provider Demographics
NPI:1962625301
Name:GLENN AND ASSOCIATES
Entity type:Organization
Organization Name:GLENN AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:RNC, CADC,MESA II, M
Authorized Official - Phone:773-684-2983
Mailing Address - Street 1:1525 E 53RD ST
Mailing Address - Street 2:SUITE 806
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4557
Mailing Address - Country:US
Mailing Address - Phone:773-684-2983
Mailing Address - Fax:773-684-2671
Practice Address - Street 1:1525 E 53RD ST
Practice Address - Street 2:SUITE 806
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4557
Practice Address - Country:US
Practice Address - Phone:773-684-2983
Practice Address - Fax:773-684-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty