Dewitt-Glickman, Susan A

Dewitt-Glickman, Susan A is an individual health care provider with primary practice located at 3 Family Practice Drive Family Practice Center, Kingston NY 12401. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Psychiatry. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dewitt-Glickman, Susan A can be contacted via phone (845) 338-2562.

Contact Information

Primary practice address
3 Family Practice Drive Family Practice Center Kingston NY 12401
Phone: (845) 338-2562
Fax: (845) 338-8909
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X PR039985-1 New York
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X PR0399851 New York

Profile Details

NPI number 1104927862
LBN Legal business name Dewitt-Glickman, Susan A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104927862 NPPES
New York MEDICAID 00733871

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