Provider Demographics
NPI:1083305205
Name:CLARISSA HUMMEL CLARE
Entity Type:Organization
Organization Name:CLARISSA HUMMEL CLARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:CLARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMMEL CLARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-718-6298
Mailing Address - Street 1:3207 SEISHOLTZVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BARTO
Mailing Address - State:PA
Mailing Address - Zip Code:19504-9039
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3207 SEISHOLTZVILLE RD
Practice Address - Street 2:
Practice Address - City:BARTO
Practice Address - State:PA
Practice Address - Zip Code:19504-9039
Practice Address - Country:US
Practice Address - Phone:267-718-6298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health