Provider Demographics
NPI:1114440476
Name:GLENN, SADE ASHANTI (LPC)
Entity Type:Individual
Prefix:
First Name:SADE
Middle Name:ASHANTI
Last Name:GLENN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SADE
Other - Middle Name:ASHANTI
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:79 E RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1207
Mailing Address - Country:US
Mailing Address - Phone:732-561-8555
Mailing Address - Fax:
Practice Address - Street 1:79 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1207
Practice Address - Country:US
Practice Address - Phone:732-561-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health