Provider Demographics
NPI:1235421025
Name:GLUSMAN MCALLISTER, LAUREA CAROLINE (MSW, MDIV, LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREA
Middle Name:CAROLINE
Last Name:GLUSMAN MCALLISTER
Suffix:
Gender:F
Credentials:MSW, MDIV, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 TRILLIUM WHORL CT STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7041
Mailing Address - Country:US
Mailing Address - Phone:919-335-8019
Mailing Address - Fax:
Practice Address - Street 1:3321 TRILLIUM WHORL CT STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7041
Practice Address - Country:US
Practice Address - Phone:919-335-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0064321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
12589855OtherCAQH PROVIDER ID