Provider Demographics
NPI:1235208331
Name:GLASSEL, MORTON L (LCSW)
Entity Type:Individual
Prefix:
First Name:MORTON
Middle Name:L
Last Name:GLASSEL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CROOKED HILL ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-5415
Mailing Address - Country:US
Mailing Address - Phone:631-462-6726
Mailing Address - Fax:631-385-8492
Practice Address - Street 1:35 CROOKED HILL ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-5415
Practice Address - Country:US
Practice Address - Phone:631-462-6726
Practice Address - Fax:631-385-8492
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR037849-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN31231Medicare ID - Type Unspecified
N31231Medicare UPIN