Provider Demographics
NPI:1417149501
Name:GLOSTER, LORI ANGELA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANGELA
Last Name:GLOSTER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3308
Mailing Address - Country:US
Mailing Address - Phone:301-962-1805
Mailing Address - Fax:301-315-0918
Practice Address - Street 1:932 HUNGERFORD DR STE 18B
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1751
Practice Address - Country:US
Practice Address - Phone:301-315-0916
Practice Address - Fax:301-315-0918
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD120371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical