Provider Demographics
NPI:1073274353
Name:TRUMBULL, CLAIRE ELLEN (LMSW)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELLEN
Last Name:TRUMBULL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1453
Mailing Address - Country:US
Mailing Address - Phone:515-776-9167
Mailing Address - Fax:515-241-5127
Practice Address - Street 1:1212 PLEASANT ST STE 406
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1413
Practice Address - Country:US
Practice Address - Phone:515-241-8336
Practice Address - Fax:515-241-6465
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1074611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical