Provider Demographics
NPI:1457803595
Name:GLESSNER, LISA J (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:GLESSNER
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 1:519 RENEE DR
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-4734
Mailing Address - Country:US
Mailing Address - Phone:412-417-5779
Mailing Address - Fax:724-850-7778
Practice Address - Street 1:1 NORTHGATE SQ STE 216
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1375
Practice Address - Country:US
Practice Address - Phone:412-256-8256
Practice Address - Fax:888-971-4394
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW150601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical