Provider Demographics
NPI:1497795108
Name:GLAZER, LINDA K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:K
Last Name:GLAZER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DARLEY RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4635
Mailing Address - Country:US
Mailing Address - Phone:516-773-7738
Mailing Address - Fax:516-773-7738
Practice Address - Street 1:20 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2122
Practice Address - Country:US
Practice Address - Phone:516-829-3924
Practice Address - Fax:516-773-7738
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO28115-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist