Provider Demographics
NPI:1083931505
Name:GLEISSNER, DONNA MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIE
Last Name:GLEISSNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SHELTER ROCK RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7050
Mailing Address - Country:US
Mailing Address - Phone:203-779-4197
Mailing Address - Fax:203-794-1967
Practice Address - Street 1:24 SHELTER ROCK RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7050
Practice Address - Country:US
Practice Address - Phone:203-794-1975
Practice Address - Fax:203-794-1967
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000231101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor