Provider Demographics
NPI:1053697185
Name:GLASSMIRE-POLICARI, JENNIFER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:GLASSMIRE-POLICARI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 ENGLEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3978
Mailing Address - Country:US
Mailing Address - Phone:321-693-7428
Mailing Address - Fax:
Practice Address - Street 1:120 PROVIDENCE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2273
Practice Address - Country:US
Practice Address - Phone:321-693-7428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4165103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical