Provider Demographics
NPI:1881978922
Name:GLEBA, MARIA (CASAC-T)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GLEBA
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-1812
Mailing Address - Country:US
Mailing Address - Phone:718-360-8157
Mailing Address - Fax:718-439-3965
Practice Address - Street 1:5220 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-1812
Practice Address - Country:US
Practice Address - Phone:718-360-8157
Practice Address - Fax:718-439-3965
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor