Provider Demographics
NPI:1194714048
Name:GLAUSER, EDWARD STEPHEN (LPC)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:STEPHEN
Last Name:GLAUSER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HUNTINGTON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7204
Mailing Address - Country:US
Mailing Address - Phone:706-202-3590
Mailing Address - Fax:706-543-2397
Practice Address - Street 1:1 HUNTINGTON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7204
Practice Address - Country:US
Practice Address - Phone:706-202-3590
Practice Address - Fax:706-543-2397
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health