Provider Demographics
NPI:1285832584
Name:GLEAN-BRILLANT, CRESSADA THERESA (MA,LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CRESSADA
Middle Name:THERESA
Last Name:GLEAN-BRILLANT
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:CRESSADA
Other - Middle Name:THERESA
Other - Last Name:GLEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1026 E 59TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2506
Mailing Address - Country:US
Mailing Address - Phone:347-312-2249
Mailing Address - Fax:
Practice Address - Street 1:300 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2812
Practice Address - Country:US
Practice Address - Phone:718-622-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health