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General NPI Number Information
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NPI Number | 1609421833
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Entity Type | Individual
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Provider Name | SANDRA HELEN GLASTETTER CASAC, SOCIAL WORKER
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Gender | Female
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 125 FINNEY BLVD
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City | MALONE
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State | NY
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Zip | 12953-1067
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Country | US
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Telephone | 518-481-8160
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Fax | 518-481-8161
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Provider Business Mailing Address
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Address Line | 17012 STATE ROUTE 30
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City | CONSTABLE
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State | NY
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Zip | 12926-3621
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 27497
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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 |
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License Number State |
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