Provider Demographics
NPI:1891716650
Name:GLICKSTEIN, CYNTHIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:GLICKSTEIN
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 1:9960 63RD RD
Mailing Address - Street 2:9S
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1946
Mailing Address - Country:US
Mailing Address - Phone:917-327-6323
Mailing Address - Fax:
Practice Address - Street 1:9960 63RD RD
Practice Address - Street 2:9S
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1946
Practice Address - Country:US
Practice Address - Phone:718-730-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054235-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical