Individual provider Active NPI

Dena Glazer, LMSW

  • Social Worker
  • Brodheadsville, PA
National Provider Identifier
1518382803
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW132834 Issued in PA
Practice address
2071 Route 209
Pennsylvania Autism Action Center
Brodheadsville, PA 18322-7754
Phone
(570) 992-6720
NPI assigned
Feb 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW132834 PA Primary

Addresses

Primary practice location

2071 Route 209
Pennsylvania Autism Action Center
Brodheadsville, PA 18322-7754

Mailing address

2071 Route 209
Pennsylvania Autism Action Center
Brodheadsville, PA 18322-7754
Phone (570) 992-6720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW132834PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1518382803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 ROUTE 209",
            "address_2": "PENNSYLVANIA AUTISM ACTION CENTER",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183227754",
            "telephone_number": "570-992-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 ROUTE 209",
            "address_2": "PENNSYLVANIA AUTISM ACTION CENTER",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183227754",
            "telephone_number": "570-992-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "DENA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW132834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brodheadsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.