Individual
DR. JACOB DRAULT GLICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, MA, LPC
Contact information
Practice address
4441 SANSOM ST, PHILADELPHIA, PA 19104-2915
(267) 223-7931
Mailing address
4441 SANSOM ST, PHILADELPHIA, PA 19104-2915
(267) 223-7931
(267) 247-3030
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC011819
PA
103TC0700X
Clinical Psychologist
Primary
PS019712
PA
Other
Enumeration date
06/23/2014
Last updated
09/26/2025
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