Provider Demographics
NPI:1730872060
Name:GLACKIN, GILLIAN (LMFT)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:
Last Name:GLACKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 S DECATUR ST UNIT A1
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17579-1436
Mailing Address - Country:US
Mailing Address - Phone:717-745-2606
Mailing Address - Fax:
Practice Address - Street 1:2 S DECATUR ST UNIT A1
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:PA
Practice Address - Zip Code:17579-1436
Practice Address - Country:US
Practice Address - Phone:717-745-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001520106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist