Provider Demographics
NPI:1093004624
Name:GLASCO, DAWN (LCSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:GLASCO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SOUTH AVE E
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3246
Mailing Address - Country:US
Mailing Address - Phone:908-497-3946
Mailing Address - Fax:201-333-4211
Practice Address - Street 1:590 NORTH 7TH STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2522
Practice Address - Country:US
Practice Address - Phone:908-644-9764
Practice Address - Fax:201-333-4211
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054423001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical