Individual
RICHARD B GLICKSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LISW-CP
Contact information
Practice address
1180 GILBERT ST SE, ATLANTA, GA 30316-3102
(305) 613-5552
Mailing address
1180 GILBERT ST SE, ATLANTA, GA 30316-3102
(305) 613-5552
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C0147
GA
1041C0700X
Clinical Social Worker
Primary
CSW005176
GA
Other
Enumeration date
07/11/2014
Last updated
12/10/2021
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