Provider Demographics
NPI:1447424957
Name:CLEMMINGS, CLAUDIA (MC, LAC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:CLEMMINGS
Suffix:
Gender:F
Credentials:MC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12835 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-6517
Mailing Address - Country:US
Mailing Address - Phone:602-992-7521
Mailing Address - Fax:602-992-6209
Practice Address - Street 1:12835 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-6517
Practice Address - Country:US
Practice Address - Phone:602-992-7521
Practice Address - Fax:602-992-6209
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12947101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health