Provider Demographics
NPI:1437150885
Name:CASE, CLARA ELIZABETH (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CLARA
Middle Name:ELIZABETH
Last Name:CASE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 PILOT KNOB RD
Mailing Address - Street 2:STE 190
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120
Mailing Address - Country:US
Mailing Address - Phone:651-452-1500
Mailing Address - Fax:651-452-1502
Practice Address - Street 1:2520 PILOT KNOB RD
Practice Address - Street 2:STE 190
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120
Practice Address - Country:US
Practice Address - Phone:651-452-1500
Practice Address - Fax:651-452-1502
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMC LICSW 11315104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1042826OtherPREFERRED ONE
MN548T9CAOtherBLUECROSS BLUESHIELD
MNHP18896OtherHEALTH PARTNERS
MN617822700Medicaid
MN6256242OtherUBH-MEDICA