Provider Demographics
NPI:1134378458
Name:GLAS, ORIT (LMSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:ORIT
Middle Name:
Last Name:GLAS
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 227TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4803
Mailing Address - Country:US
Mailing Address - Phone:718-884-7761
Mailing Address - Fax:
Practice Address - Street 1:1776 BROADWAY
Practice Address - Street 2:SUITE 1200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2002
Practice Address - Country:US
Practice Address - Phone:212-707-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077493104100000X
NY077042-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker