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Provider Information for 1295104941


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VANESSA ANNE GLATT LPCC


Sex: Female

NPI: 1295104941
Last Updated: 2021-01-22
Certification Date: 2021-01-15

Details

NameValue
NPI1295104941
Enumeration Date2015-09-23
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2644 30TH ST
SANTA MONICA, CA 90405-3060
United States

Phone: 310-314-6200 | Fax:
 
Primary Practice Address 2644 30TH ST
SANTA MONICA, CA 90405-3060
United States

Phone: 310-314-6200 | Fax:
 
Secondary Practice Address(es)

2369 109TH AVE NW
COON RAPIDS, MN 55433-4156
United States

Phone: 763-506-2838 | Fax:763-506-2803
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YP2500X - Counselor - ProfessionalMNcc01055
Yes 101YP2500X - Counselor - ProfessionalCA9012