# GLENN THERAPY, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nichelle Gardner, LCPC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386498087
- **Authorized official:** NICHELLE GARDNER LCPC (OWNER/LCPC)
- **Authorized official phone:** (207) 671-7804

## Contact information

- **Practice address:** 285 RAYMOND HILL RD, RAYMOND, ME 04071-6148
- **Practice address phone:** (207) 671-7804
- **Mailing address:** 285 RAYMOND HILL RD, RAYMOND, ME 04071-6148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2024
- **Last updated:** 04/17/2024