Individual
ANTONIA GLASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS, LCMHC, LCMHC-A
Contact information
Practice address
104 CAMBRIDGE PLAZA DR, WINSTON SALEM, NC 27104-3556
(336) 722-7266
(336) 201-0538
Mailing address
713 S MARSHALL ST, WINSTON SALEM, NC 27101-5808
(336) 722-7266
(336) 201-0538
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
16256
NC
Other
Enumeration date
08/27/2020
Last updated
04/05/2023
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