Provider Demographics
NPI:1245439736
Name:GLAZER, JENNIFER LEVIN (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEVIN
Last Name:GLAZER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 N FAIRFAX AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2109
Mailing Address - Country:US
Mailing Address - Phone:323-937-5900
Mailing Address - Fax:323-857-1872
Practice Address - Street 1:330 N FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2109
Practice Address - Country:US
Practice Address - Phone:323-937-5900
Practice Address - Fax:323-857-1872
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 23984104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker