Glenn Emery Degere, M.S.W., L.I.C.S.W.
Individual provider Active NPI Clinical Social Worker · Hanscom Afb, MA
NPI 1972860187 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1972860187
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 115439 (MA)
- Practice address
- 90 Vandenberg Dr BLDG 1900
Hanscom Afb, MA 01731-2104 - Phone
- (781) 225-6789
- Fax
- (781) 225-2568
- NPI assigned
- Apr 12, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115439 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 115439 | MA | Yes |
Addresses
Primary practice location
90 Vandenberg Dr BLDG 1900
Hanscom Afb, MA 01731-2104
Mailing address
25 Essex St
Athol, MA 01331-2207
Phone (781) 698-8321
Other practice location 1
25 Essex St
Athol, MA 01331-2207
Phone (781) 698-8321
Other providers in Hanscom Afb, MA
- Jay Scott Cloutier
- John F. Coke
- Sandra Elizabeth Colucci
- Callie Comstock
- Beverly A Dangelo
- David Anthony Digregorio
- Mohammed Fuad
- Andrea Lynne Galeucia
- Timothy Alan Gameros
- Charity Garland
All providers in Hanscom Afb, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.