Provider Demographics
NPI:1942369061
Name:GLADEN, LAWREN PEGGY (LCSW, PLLC)
Entity Type:Individual
Prefix:
First Name:LAWREN
Middle Name:PEGGY
Last Name:GLADEN
Suffix:
Gender:F
Credentials:LCSW, PLLC
Other - Prefix:
Other - First Name:LAWREN
Other - Middle Name:
Other - Last Name:CHALMERS-GLADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:725 WEST ALDER ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4036
Mailing Address - Country:US
Mailing Address - Phone:406-546-4690
Mailing Address - Fax:406-543-0282
Practice Address - Street 1:725 W ALDER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4036
Practice Address - Country:US
Practice Address - Phone:406-546-4690
Practice Address - Fax:406-273-0692
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical