Provider Demographics
NPI:1639211675
Name:GLASER, JAMIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GLASER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical