Provider Demographics
NPI:1740491919
Name:GLAZIER, SHERI G (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:G
Last Name:GLAZIER
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 1:13 BRENTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4201
Mailing Address - Country:US
Mailing Address - Phone:207-942-5886
Mailing Address - Fax:
Practice Address - Street 1:13 BRENTWOOD AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4201
Practice Address - Country:US
Practice Address - Phone:207-974-6454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC99211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical