| Susie Glick Therapist Inc | |
|
3478 Imperata Dr Rockledge FL 32955-6089 | |
| (321) 446-0126 | |
| Not Available |
| Full Name | Susie Glick Therapist Inc |
|---|---|
| Speciality | Social Worker |
| Location | 3478 Imperata Dr, Rockledge, Florida |
| Authorized Official Name and Position | Susie Glick (PRESIDENT) |
| Authorized Official Contact | 3214460126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susie Glick Therapist Inc 3478 Imperata Dr Rockledge FL 32955-6089 Ph: () - | Susie Glick Therapist Inc 3478 Imperata Dr Rockledge FL 32955-6089 Ph: (321) 446-0126 |
| NPI Number | 1578222410 |
|---|---|
| Provider Enumeration Date | 12/08/2021 |
| Last Update Date | 12/08/2021 |
| Certification Date | 12/08/2021 |
| Medicare PECOS PAC ID | 6507259074 |
|---|---|
| Medicare Enrollment ID | O20220204000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578222410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susie C Glick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205162286 PECOS PAC ID: 2567505654 Enrollment ID: I20100212000050 |
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