Provider Demographics
NPI:1760545982
Name:GLASSMAN, NEIL A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:A
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 COLBY PL
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1742
Mailing Address - Country:US
Mailing Address - Phone:732-972-6564
Mailing Address - Fax:732-888-7767
Practice Address - Street 1:50 US HIGHWAY 9 N
Practice Address - Street 2:101
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1574
Practice Address - Country:US
Practice Address - Phone:732-536-2299
Practice Address - Fax:732-888-7767
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007524001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ738172Medicare ID - Type Unspecified