Provider Demographics
NPI:1619252269
Name:GLAVIANO, NANCY M (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:GLAVIANO
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 METAIRIE RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4333
Mailing Address - Country:US
Mailing Address - Phone:504-838-0021
Mailing Address - Fax:504-888-3006
Practice Address - Street 1:433 METAIRIE RD
Practice Address - Street 2:SUITE 315
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4333
Practice Address - Country:US
Practice Address - Phone:504-838-0021
Practice Address - Fax:504-888-3006
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2395101YP2500X
LA518106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist