Provider Demographics
NPI:1770529521
Name:GLATT, ADAM M (LMHC, LPC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:M
Last Name:GLATT
Suffix:
Gender:M
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4714
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-0012
Mailing Address - Country:US
Mailing Address - Phone:804-302-5169
Mailing Address - Fax:866-348-6656
Practice Address - Street 1:4920 MILLRIDGE PKWY E STE 216
Practice Address - Street 2:MARKET SQUARE CENTER
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4857
Practice Address - Country:US
Practice Address - Phone:804-302-5169
Practice Address - Fax:866-348-6656
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 3216101YM0800X
VA0701005187101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health