Provider Demographics
NPI:1467434266
Name:ATCHLEY, CLARA HAYNES (LCSW,LPC)
Entity Type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:HAYNES
Last Name:ATCHLEY
Suffix:
Gender:F
Credentials:LCSW,LPC
Other - Prefix:
Other - First Name:LIFEWORKS
Other - Middle Name:
Other - Last Name:RPLLP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:GROUP PRACTICE
Mailing Address - Street 1:205 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3449
Mailing Address - Country:US
Mailing Address - Phone:828-433-9190
Mailing Address - Fax:828-433-9130
Practice Address - Street 1:205 E UNION ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3449
Practice Address - Country:US
Practice Address - Phone:828-433-9190
Practice Address - Fax:828-433-9130
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0361101YP2500X
NCC0011091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002821Medicaid
NC2035081OtherCIGNA BEHAVIORAL HEALTH
NC95161OtherMEDCOST
NC6292342OtherUNITED BEHAVIORAL
NC1215AOtherBCBS INDIVIDUAL