Provider Demographics
NPI:1700030210
Name:GLAVIANO, CECELIA A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:A
Last Name:GLAVIANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61518 HIGHWAY 1091
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:LA
Mailing Address - Zip Code:70452-3316
Mailing Address - Country:US
Mailing Address - Phone:985-643-2618
Mailing Address - Fax:985-643-2618
Practice Address - Street 1:61518 HIGHWAY 1091
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:LA
Practice Address - Zip Code:70452-3316
Practice Address - Country:US
Practice Address - Phone:985-768-0553
Practice Address - Fax:985-768-0553
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA50201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical