Provider Demographics
NPI:1245849348
Name:GLIDEWELL, JAMIE ANNE (LICSW, LCSW-C, APHSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANNE
Last Name:GLIDEWELL
Suffix:
Gender:F
Credentials:LICSW, LCSW-C, APHSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 ROCKVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:301-319-2899
Mailing Address - Fax:301-400-3050
Practice Address - Street 1:8901 ROCKVILLE PIKE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-319-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21646101YM0800X
DCLC50082273101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG-434-366-067-341OtherDRIVER'S LICENSE
DCLC50082273OtherLICSW
MD21646OtherLCSW-C