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General NPI Number Information
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NPI Number | 1457844425
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Entity Type | Individual
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Provider Name | REBECCA LAUREN GLASSMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 14732 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11435-4082
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Country | US
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Telephone | 718-349-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 308 E BROAD ST
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City | BETHLEHEM
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State | PA
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Zip | 18018-6311
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Country | US
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Telephone | 732-757-7532
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 096366
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW134440
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License Number State | PA
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