Provider Demographics
NPI:1386655025
Name:PAICE, CLAIRE MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:MARIE
Last Name:PAICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KERRY
Other - Middle Name:MARIE
Other - Last Name:PAICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2207 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-2930
Mailing Address - Country:US
Mailing Address - Phone:315-428-8844
Mailing Address - Fax:315-428-8304
Practice Address - Street 1:2207 BURNET AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-2930
Practice Address - Country:US
Practice Address - Phone:315-428-8844
Practice Address - Fax:315-428-8304
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0287751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01670626Medicaid
NYCC2832Medicare ID - Type Unspecified
NYRA7973Medicare PIN
NYR55956Medicare UPIN