Provider Demographics
NPI:1093069932
Name:CLOUSER, PATRICIA (LSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CLOUSER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 LEONARD STREET
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3200
Mailing Address - Country:US
Mailing Address - Phone:814-205-4004
Mailing Address - Fax:814-205-4013
Practice Address - Street 1:850 LEONARD STREET
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3200
Practice Address - Country:US
Practice Address - Phone:814-205-4004
Practice Address - Fax:814-205-4013
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0194751041C0700X
PASW129932104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical