Individual
MR. GLEN THOMAS SEGOND
Active
Individual
MR. GLEN THOMAS SEGOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
44SC05112500
NJ
1041C0700X
Clinical Social Worker
Primary
CW004643L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5013039
AETNA PROVIDER NUMBER
PA
01
—
SE690000
HIGHMARK BS FED EMPL PROV
PA
Enumeration date
08/31/2006
Last updated
07/08/2007
Update your record
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