Provider Demographics
NPI:1477606200
Name:GLAZER, BONNIE L (LCSW R ACSW)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:L
Last Name:GLAZER
Suffix:
Gender:F
Credentials:LCSW R ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5734
Mailing Address - Country:US
Mailing Address - Phone:716-818-1173
Mailing Address - Fax:716-631-2783
Practice Address - Street 1:5820 MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5734
Practice Address - Country:US
Practice Address - Phone:716-818-1173
Practice Address - Fax:716-631-2783
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR014189-11041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical