Healthcare Provider Details

I. General information

NPI: 1053361139
Provider Name (Legal Business Name): CORINNE L GLASSMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 MAIN ST
ROBBINSVILLE NJ
08691-1420
US

IV. Provider business mailing address

13 MAIN ST
ROBBINSVILLE NJ
08691-1420
US

V. Phone/Fax

Practice location:
  • Phone: 609-259-3839
  • Fax: 609-259-2342
Mailing address:
  • Phone: 609-259-3839
  • Fax: 609-259-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC44076
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: