Provider Demographics
NPI:1437298692
Name:DODRILL, CLAUDIA JANE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:JANE
Last Name:DODRILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 PIER DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-6118
Mailing Address - Country:US
Mailing Address - Phone:813-641-0949
Mailing Address - Fax:
Practice Address - Street 1:2407 PIER DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-6118
Practice Address - Country:US
Practice Address - Phone:813-641-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW32421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5576YMedicare ID - Type Unspecified