Provider Demographics
NPI:1902181910
Name:SYLVESTER, GLENER SEWELL (LCSW,BACS,C-SSWS)
Entity Type:Individual
Prefix:MS
First Name:GLENER
Middle Name:SEWELL
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LCSW,BACS,C-SSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 MARIGNY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5041
Mailing Address - Country:US
Mailing Address - Phone:504-453-5635
Mailing Address - Fax:504-282-2227
Practice Address - Street 1:4600 MARIGNY ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5041
Practice Address - Country:US
Practice Address - Phone:504-453-5635
Practice Address - Fax:504-282-2227
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13381041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool