Provider Demographics
NPI:1770723942
Name:DEBRA S. GLUCK, MSW, LCSW, LLC
Entity type:Organization
Organization Name:DEBRA S. GLUCK, MSW, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:GLUCK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:732-455-3870
Mailing Address - Street 1:3301 ROUTE 66
Mailing Address - Street 2:BUILDING B, SUITE 106
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2705
Mailing Address - Country:US
Mailing Address - Phone:732-455-3870
Mailing Address - Fax:732-455-3872
Practice Address - Street 1:3301 ROUTE 66
Practice Address - Street 2:BUILDING B, SUITE 106
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-2705
Practice Address - Country:US
Practice Address - Phone:732-455-3870
Practice Address - Fax:732-455-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty