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General NPI Number Information
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NPI Number | 1467737221
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Entity Type | Individual
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Provider Name | DAVID M. GLICKMAN LPC
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Gender | Male
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 313 S 16TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4908
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Country | US
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Telephone | 215-290-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SABINE AVE
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City | NARBERTH
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State | PA
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Zip | 19072-1720
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Country | US
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Telephone | 215-290-0222
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC006052
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License Number State | PA
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