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General NPI Number Information
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NPI Number | 1619010709
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Entity Type | Organization
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Legal Business Name | STANLEY GLICK, LCSW, BCD, P.C.
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 11/16/2009
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Provider Practice Location Address
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Address Line | 412 EXECUTIVE DR
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City | LANGHORNE
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State | PA
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Zip | 19047-8003
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Country | US
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Telephone | 215-321-1435
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Fax | 215-369-8258
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Provider Business Mailing Address
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Address Line | 412 EXECUTIVE DR
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City | LANGHORNE
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State | PA
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Zip | 19047-8003
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Country | US
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Telephone | 215-321-1435
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Fax | 215-369-8258
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANLEY GLICK
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Credential | LCSW
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Telephone | 215-321-1435
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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 | 44SC00078900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW000778L
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License Number State | PA
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