Provider Demographics
NPI:1487869814
Name:GLICKEN, NAOMI JOYCE (LCSW)
Entity type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:JOYCE
Last Name:GLICKEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 W 90TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1532
Mailing Address - Country:US
Mailing Address - Phone:212-877-7072
Mailing Address - Fax:212-928-8392
Practice Address - Street 1:49 W 86TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4022
Practice Address - Country:US
Practice Address - Phone:212-877-7072
Practice Address - Fax:212-928-8392
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO15297-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical