Provider Demographics
NPI:1386144178
Name:GLADYS' COUNSELING PLACE, PLLC-WHERE LIFE'S MOMENTS MAKE YOU STRONGER
Entity type:Organization
Organization Name:GLADYS' COUNSELING PLACE, PLLC-WHERE LIFE'S MOMENTS MAKE YOU STRONGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:AC
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-490-8384
Mailing Address - Street 1:240 ORCHARD HILL DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-3025
Mailing Address - Country:US
Mailing Address - Phone:860-490-8384
Mailing Address - Fax:
Practice Address - Street 1:240 ORCHARD HILL DR
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-3025
Practice Address - Country:US
Practice Address - Phone:860-490-8384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-18
Last Update Date:2018-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0095971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty