Provider Demographics
NPI:1700933280
Name:GLENDENING, SUSAN MAE (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MAE
Last Name:GLENDENING
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 1:2 RIVERBANK LANE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12520
Mailing Address - Country:US
Mailing Address - Phone:845-534-9124
Mailing Address - Fax:
Practice Address - Street 1:2 RIVERBANK LANE
Practice Address - Street 2:
Practice Address - City:CORNWALL ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12520
Practice Address - Country:US
Practice Address - Phone:845-534-9124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP14190R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical