Provider Demographics
NPI:1861179814
Name:RODRIGUEZ PARRILLA, GLIMAR ZOE (LICSW, LADCI, MA PGS)
Entity type:Individual
Prefix:
First Name:GLIMAR
Middle Name:ZOE
Last Name:RODRIGUEZ PARRILLA
Suffix:
Gender:F
Credentials:LICSW, LADCI, MA PGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 GROVE ST UNIT 344
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7209
Mailing Address - Country:US
Mailing Address - Phone:617-466-9674
Mailing Address - Fax:
Practice Address - Street 1:288 GROVE ST UNIT 344
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7209
Practice Address - Country:US
Practice Address - Phone:617-466-9674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2270241041C0700X
MALICSW1277701041C0700X
MA13523101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)