Provider Demographics
NPI:1598103301
Name:JAMIE M GLASER LLC
Entity Type:Organization
Organization Name:JAMIE M GLASER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-C
Authorized Official - Phone:443-966-0370
Mailing Address - Street 1:10 TIPPERARY CT
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1136
Mailing Address - Country:US
Mailing Address - Phone:443-966-0370
Mailing Address - Fax:410-882-6312
Practice Address - Street 1:1809 E JOPPA RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-2709
Practice Address - Country:US
Practice Address - Phone:410-661-0284
Practice Address - Fax:410-882-6312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty