Provider Demographics
NPI:1740456177
Name:STITH, GLADYS (LCSW)
Entity type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:
Last Name:STITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GLADYS
Other - Middle Name:ADAMS
Other - Last Name:STITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3341 SANTA MONICA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5895
Mailing Address - Country:US
Mailing Address - Phone:407-380-2777
Mailing Address - Fax:407-381-7009
Practice Address - Street 1:3341 SANTA MONICA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-5895
Practice Address - Country:US
Practice Address - Phone:407-739-3341
Practice Address - Fax:407-381-7009
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical