Healthcare Provider Details

I. General information

NPI: 1598587719
Provider Name (Legal Business Name): MR. JAMES GLOVER JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N 25TH ST
READING PA
19606-2015
US

IV. Provider business mailing address

153 LIVINGSTON LN
EXTON PA
19341-2807
US

V. Phone/Fax

Practice location:
  • Phone: 610-779-3545
  • Fax:
Mailing address:
  • Phone: 919-527-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberSW142134
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: