Provider Demographics
NPI:1316924137
Name:GLADDEN, JORJA KATHERINE
Entity type:Individual
Prefix:MS
First Name:JORJA
Middle Name:KATHERINE
Last Name:GLADDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 DONS WAY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913
Mailing Address - Country:US
Mailing Address - Phone:501-620-5130
Mailing Address - Fax:501-620-5109
Practice Address - Street 1:125 DONS WAY
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-624-7111
Practice Address - Fax:501-620-5109
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0305020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR71-0401764OtherCORPHEALTH
AR710401764GLAOtherUNITY MANAGED MH CO.
AR116399726Medicaid
AR230308OtherCOMPSYCH
AR5X370OtherBLUE CROSS & BLUE SHIELD
AR926010OtherUSA MANAGED CARE
AR244949OtherMHN NETWORK
AR1316924137OtherNOVA SYSTEM
AR1316924137OtherTRICARE
AR2187549OtherCIGNA BEHAVIORAL HEALTH
AR576115OtherVALUE OPTIONS
ARMIS 718462000OtherMAGELLAN
AR3090013600OtherQUAL-CHOICE
AR60054OtherAETNA
AR710401764OtherMHNET