Segond, Glen Thomas
Segond, Glen Thomas is an sole proprietor health care provider with primary practice located at 117 Broad St , Stroudsburg PA 18360-1534. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Segond, Glen Thomas can be contacted via phone (570) 424-6049.Contact Information
Primary practice address
117 Broad St
Stroudsburg PA 18360-1534
Phone: (570) 424-6049
Fax: (570) 424-0917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CW004643L | Pennsylvania |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 44SC05112500 | New Jersey |
Profile Details
| NPI number | 1629189378 |
|---|---|
| LBN Legal business name | Segond, Glen Thomas |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629189378 | NPPES |
| Pennsylvania | Other | 5013039 | AETNA PROVIDER NUMBER |
| Pennsylvania | Other | SE690000 | AETNA PROVIDER NUMBER |
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