Provider Demographics
NPI:1710326368
Name:GLASSER, LINDA J (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:GLASSER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 MALCOLM AVE
Mailing Address - Street 2:5
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6845
Mailing Address - Country:US
Mailing Address - Phone:818-386-1094
Mailing Address - Fax:818-386-1182
Practice Address - Street 1:16600 SHERMAN WAY
Practice Address - Street 2:165
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3875
Practice Address - Country:US
Practice Address - Phone:818-386-1094
Practice Address - Fax:818-386-1182
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
103K00000X
CALCS139431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst