Provider Demographics
NPI:1942651112
Name:GLEICHER, JAIME LEE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:LEE
Last Name:GLEICHER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 BROADWAY APT 893
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2142
Mailing Address - Country:US
Mailing Address - Phone:917-587-0934
Mailing Address - Fax:
Practice Address - Street 1:352 7TH AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5012
Practice Address - Country:US
Practice Address - Phone:917-587-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091875-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health