Provider Demographics
NPI:1457367633
Name:GLASENER, LEWIS PAUL (LCSW,BCD)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:PAUL
Last Name:GLASENER
Suffix:
Gender:M
Credentials:LCSW,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 TAPAWINGO RD SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5976
Mailing Address - Country:US
Mailing Address - Phone:703-255-3854
Mailing Address - Fax:703-255-3854
Practice Address - Street 1:328 TAPAWINGO RD SE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5976
Practice Address - Country:US
Practice Address - Phone:703-255-3854
Practice Address - Fax:703-255-3854
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical