Provider Demographics
NPI:1104826007
Name:LASWELL, GLENDA S III (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GLENDA
Middle Name:S
Last Name:LASWELL
Suffix:III
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 1:260 MERRIMON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1218
Mailing Address - Country:US
Mailing Address - Phone:828-255-8655
Mailing Address - Fax:828-255-8591
Practice Address - Street 1:260 MERRIMON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1218
Practice Address - Country:US
Practice Address - Phone:828-255-8655
Practice Address - Fax:828-255-8591
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0013711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2865784Medicare ID - Type Unspecified