Provider Demographics
NPI:1134782774
Name:GLADDEN, DANIEL II (MBA, MSW, LCSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GLADDEN
Suffix:II
Gender:M
Credentials:MBA, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 M ST APT 105
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3351
Mailing Address - Country:US
Mailing Address - Phone:314-941-3675
Mailing Address - Fax:
Practice Address - Street 1:360 W BENSON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3953
Practice Address - Country:US
Practice Address - Phone:075-651-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140331791041C0700X
AK1329221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical