Provider Demographics
NPI:1659458446
Name:GLASSEL, ARLINE MAE (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:ARLINE
Middle Name:MAE
Last Name:GLASSEL
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MISS
Other - First Name:ARLINE
Other - Middle Name:MAE
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4 BAYVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1505
Mailing Address - Country:US
Mailing Address - Phone:631-424-3696
Mailing Address - Fax:631-385-8492
Practice Address - Street 1:35 CROOKED HILL ROAD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-5411
Practice Address - Country:US
Practice Address - Phone:631-462-6843
Practice Address - Fax:631-385-8492
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSWR0226631041C0700X
NJLCSWSC018911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN00081Medicare ID - Type Unspecified