Provider Demographics
NPI:1982884573
Name:GLEDHILL, NORINE (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:NORINE
Middle Name:
Last Name:GLEDHILL
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SALEM LN
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1210
Mailing Address - Country:US
Mailing Address - Phone:631-601-3712
Mailing Address - Fax:
Practice Address - Street 1:565 ROUTE 25A STE LR2
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2665
Practice Address - Country:US
Practice Address - Phone:631-601-3712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073621104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker