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General NPI Number Information
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NPI Number | 1457719379
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Entity Type | Individual
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Provider Name | GLORIANN J DESLIENS LCSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 02/06/2016
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2400 CALLOWAY DR
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City | ORLANDO
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State | FL
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Zip | 32810-2138
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Country | US
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Telephone | 386-214-7934
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 CALLOWAY DR
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City | ORLANDO
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State | FL
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Zip | 32810-2138
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Country | US
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Telephone | 386-214-7934
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Fax | 888-662-5340
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LICSW126823
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ISW 9895
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW15476
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License Number State | FL
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