| Sade Ashanti Glenn, LPC | |
|
79 E Railroad Ave, Jamesburg, NJ 08831-1207 | |
| (732) 561-8555 | |
| Not Available |
| Full Name | Sade Ashanti Glenn |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 79 E Railroad Ave, Jamesburg, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114440476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | Theracorp, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063947828 PECOS PAC ID: 8426319104 Enrollment ID: O20180220001235 |
| Mailing Address | Practice Location Address |
|---|---|
| Sade Ashanti Glenn, LPC 79 E Railroad Ave, Jamesburg, NJ 08831-1207 Ph: (732) 561-8555 | Sade Ashanti Glenn, LPC 79 E Railroad Ave, Jamesburg, NJ 08831-1207 Ph: (732) 561-8555 |
Marguerite Villepontoux, Counselor Medicare: Not Enrolled in Medicare Practice Location: 79 E Railroad Ave, Jamesburg, NJ 08831 Phone: 732-561-8555 Fax: 732-561-1165 | |
Mary Kate George, Counselor Medicare: Not Enrolled in Medicare Practice Location: 79 E Railroad Ave, Jamesburg, NJ 08831 Phone: 732-561-8555 | |
Mrs. Alla Krutyansky, MSW, LSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 79 E Railroad Ave, Jamesburg, NJ 08831 Phone: 732-561-8555 Fax: 973-836-0349 | |
Laura Sansum, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 79 E Railroad Ave, Jamesburg, NJ 08831 Phone: 732-561-8555 | |
Lauren N Bennett, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 79 E Railroad Ave, Jamesburg, NJ 08831 Phone: 732-561-8555 | |
Leslie F Small, MS LPC Counselor Medicare: Medicare Enrolled Practice Location: 9 Davison Ave, Suite #3, Jamesburg, NJ 08831 Phone: 732-997-0214 |