Provider Demographics
NPI:1841170016
Name:GLICK, HILLARY
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:GLICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:
Other - Last Name:SAMUELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, EDM, LEP
Mailing Address - Street 1:2 ELM SQ STE 311
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3668
Mailing Address - Country:US
Mailing Address - Phone:978-852-0727
Mailing Address - Fax:
Practice Address - Street 1:2 ELM SQ STE 311
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3668
Practice Address - Country:US
Practice Address - Phone:978-852-0727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALEP0000188103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool