Provider Demographics
NPI:1871509992
Name:GLASS, JOANNE B (LCSW)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:B
Last Name:GLASS
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 1:935 REDGATE AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1517
Mailing Address - Country:US
Mailing Address - Phone:757-668-6100
Mailing Address - Fax:757-668-6109
Practice Address - Street 1:935 REDGATE AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1517
Practice Address - Country:US
Practice Address - Phone:757-668-6100
Practice Address - Fax:757-668-6109
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040004781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical