Glenn Emery Degere, M.S.W., L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115439 Issued in 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

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972860187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ESSEX ST",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013312207",
            "telephone_number": "781-698-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 VANDENBERG DR BLDG 1900",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "017312104",
            "telephone_number": "781-225-6789",
            "fax_number": "781-225-2568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Essex St",
            "address_purpose": "LOCATION",
            "city": "Athol",
            "state": "MA",
            "postal_code": "013312207",
            "country_code": "US",
            "telephone_number": "781-698-8321",
            "fax_number": "978-249-2832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGERE",
        "first_name": "GLENN",
        "middle_name": "EMERY",
        "name_prefix": "Mr.",
        "credential": "M.S.W., L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John F. Coke, D.D.S.
• Melissa Collazo, LCSW
• Sandra Elizabeth Colucci, PHARM.D
• Callie Comstock
• Beverly A Dangelo, LICSW
• David Anthony Digregorio, PA-C
• Mohammed Fuad, PA-C
• Andrea Lynne Galeucia, LICSW; BCD
• Timothy Alan Gameros, PSYCHOLOGIST
• John David Gerhauser, DMD

• Clinical Social Worker in Hanscom AFB, MA
• Providers in Hanscom AFB, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.