Basic Information
| Provider Information | |||||||||
| NPI: | 1760935670 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GLASENER | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LICDC-CS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8411 BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441053932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162065201 | ||||||||
| FaxNumber: | 2164413637 | ||||||||
| Practice Location | |||||||||
| Address1: | 8411 BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441053932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162065201 | ||||||||
| FaxNumber: | 2164413637 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2016 | ||||||||
| LastUpdateDate: | 07/27/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | E.0003673 | OH | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.