Gladys L Cudjoe, LCSW, MASTER-CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091375 Issued in NY

Practice address

36 Joyce Ave
Massapequa, NY 11758-3729

Phone

(718) 506-7156

NPI assigned

Oct 20, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Gladys L Salizan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1063884823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 JOYCE AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117583729",
            "telephone_number": "718-506-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 JOYCE AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117583729",
            "telephone_number": "718-506-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDJOE",
        "first_name": "GLADYS",
        "middle_name": "L",
        "credential": "LCSW, MASTER-CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "28147",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLADYS",
            "last_name": "SALIZAN",
            "middle_name": "L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Social Worker in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.