Provider Demographics
NPI:1962741488
Name:CAROL G. GLASER, PHD
Entity type:Organization
Organization Name:CAROL G. GLASER, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:G
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-833-8822
Mailing Address - Street 1:641 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2203
Mailing Address - Country:US
Mailing Address - Phone:201-833-8822
Mailing Address - Fax:
Practice Address - Street 1:641 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2203
Practice Address - Country:US
Practice Address - Phone:201-833-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100140100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty