Provider Demographics
NPI:1235265489
Name:GLOVER, JENNIFER LINDA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LINDA
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4332 KISSENA BLVD
Mailing Address - Street 2:APT 16M
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2934
Mailing Address - Country:US
Mailing Address - Phone:718-353-0653
Mailing Address - Fax:
Practice Address - Street 1:14015B SANFORD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2557
Practice Address - Country:US
Practice Address - Phone:718-358-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065988104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker