Individual
MR. THOMAS EVERS GLENDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
411 CONGRESS ST, PORTLAND, ME 04101-3505
(207) 831-6260
(207) 681-5385
Mailing address
615 CONGRESS ST STE 601F, PORTLAND, ME 04101-3343
(207) 831-6260
(207) 681-5385
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6973
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047825
ANTHEM PROVIDER ID
—
Enumeration date
03/21/2006
Last updated
10/13/2023
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