Provider Demographics
NPI:1982820049
Name:GLASSMAN, CAROL (LCSW, DSW)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:GLASSMAN
Suffix:
Gender:F
Credentials:LCSW, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 PERRY STREET
Mailing Address - Street 2:4K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2475
Mailing Address - Country:US
Mailing Address - Phone:212-929-9746
Mailing Address - Fax:
Practice Address - Street 1:167 PERRY STREET
Practice Address - Street 2:4K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2475
Practice Address - Country:US
Practice Address - Phone:212-929-9746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR020894-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN25801Medicare ID - Type Unspecified