Provider Demographics
NPI:1467448720
Name:DEAN, CLAIRE SUSAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:SUSAN
Last Name:DEAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:S
Other - Last Name:WITTELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:4500 COOPER RD STE 303
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5600
Mailing Address - Country:US
Mailing Address - Phone:513-940-7175
Mailing Address - Fax:513-940-7176
Practice Address - Street 1:4500 COOPER RD STE 303
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5600
Practice Address - Country:US
Practice Address - Phone:513-940-7175
Practice Address - Fax:513-940-7176
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042031A103TC0700X
OH6827103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11500907OtherCAQH