Provider Demographics
NPI:1629320346
Name:GLICKER, FRANCES (MENTAL HEATH COUNCEL)
Entity Type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:
Last Name:GLICKER
Suffix:
Gender:F
Credentials:MENTAL HEATH COUNCEL
Other - Prefix:MRS
Other - First Name:FRANCES
Other - Middle Name:
Other - Last Name:GLICKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:10440 QUEENS BLVD
Mailing Address - Street 2:20C
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3637
Mailing Address - Country:US
Mailing Address - Phone:718-789-8392
Mailing Address - Fax:718-230-1901
Practice Address - Street 1:10440 QUEENS BLVD
Practice Address - Street 2:20C
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3637
Practice Address - Country:US
Practice Address - Phone:718-789-8392
Practice Address - Fax:718-230-1901
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064428-1101YM0800X
NY004134-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health