1629320346 NPI number — MRS. FRANCES GLICKER MENTAL HEATH COUNCEL

Table of content: MRS. FRANCES GLICKER MENTAL HEATH COUNCEL (NPI 1629320346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629320346 NPI number — MRS. FRANCES GLICKER MENTAL HEATH COUNCEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GLICKER
Provider First Name:
FRANCES
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MENTAL HEATH COUNCEL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GLICKER
Provider Other First Name:
FRANCES
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1629320346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10440 QUEENS BLVD
Provider Second Line Business Mailing Address:
20C
Provider Business Mailing Address City Name:
FOREST HILLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11375-3637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-789-8392
Provider Business Mailing Address Fax Number:
718-230-1901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10440 QUEENS BLVD
Provider Second Line Business Practice Location Address:
20C
Provider Business Practice Location Address City Name:
FOREST HILLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11375-3637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-789-8392
Provider Business Practice Location Address Fax Number:
718-230-1901
Provider Enumeration Date:
10/04/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  064428-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: 004134-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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