Individual
MS. GWEN A GLATTHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS,LCMHC
Contact information
Practice address
211 E SIX FORKS RD STE 117, RALEIGH, NC 27609-7753
(215) 970-3373
Mailing address
3100 LONG MEADOW CT APT 202, RALEIGH, NC 27613-3215
(215) 970-3373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1055
NC
101YM0800X
Mental Health Counselor
Primary
4993
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891819777
—
NC
05
—
6005246
—
NC
Enumeration date
03/18/2007
Last updated
05/10/2024
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