| Phara Gladden,lcsw,pllc | |
|
978 Route 45 Suite 104 Pomona NY 10970-3521 | |
| (845) 596-8006 | |
| Not Available |
| Full Name | Phara Gladden,lcsw,pllc |
|---|---|
| Speciality | Social Worker |
| Location | 978 Route 45, Pomona, New York |
| Authorized Official Name and Position | Phara Gladden (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8455968006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phara Gladden,lcsw,pllc Po Box 20 Blauvelt NY 10913-0020 Ph: (845) 596-8006 | Phara Gladden,lcsw,pllc 978 Route 45 Suite 104 Pomona NY 10970-3521 Ph: (845) 596-8006 |
| NPI Number | 1457709529 |
|---|---|
| Provider Enumeration Date | 05/31/2016 |
| Last Update Date | 05/31/2016 |
| Medicare PECOS PAC ID | 1658667209 |
|---|---|
| Medicare Enrollment ID | O20160907001962 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457709529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 075198 (New York) | Primary |
| Provider Name | Phara Gladden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295081545 PECOS PAC ID: 9638465297 Enrollment ID: I20160907002154 |
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Rockland County Dept Of Mental Health Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 50 Sanitorium Rd, Building F-room 240, Pomona, NY 10970 Phone: 845-364-2334 | |
Rockland County Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Sanitorium Rd, Bldg F, Pomona, NY 10970 Phone: 845-364-2334 |