Provider Demographics
NPI:1003970146
Name:DONCH, CLAIRE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:
Last Name:DONCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WEST 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502
Mailing Address - Country:US
Mailing Address - Phone:814-455-4009
Mailing Address - Fax:814-455-7715
Practice Address - Street 1:301 WEST 10TH STREET
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502
Practice Address - Country:US
Practice Address - Phone:814-455-4009
Practice Address - Fax:814-455-7715
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014867103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
089881Medicare ID - Type Unspecified