Provider Demographics
NPI:1821260662
Name:GLASCO, JINNY L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JINNY
Middle Name:L
Last Name:GLASCO
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 1:105 MUSIC VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2714
Mailing Address - Country:US
Mailing Address - Phone:615-824-3772
Mailing Address - Fax:
Practice Address - Street 1:105 MUSIC VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2714
Practice Address - Country:US
Practice Address - Phone:615-824-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW47731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441385Medicaid
TN3725609Medicare UPIN