Provider Demographics
NPI:1215646005
Name:GLIDDEN, CAROLINE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:GLIDDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HARDING RD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2413
Mailing Address - Country:US
Mailing Address - Phone:732-757-1021
Mailing Address - Fax:
Practice Address - Street 1:300 HARDING RD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2413
Practice Address - Country:US
Practice Address - Phone:732-757-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ92-0503856Medicaid