Provider Demographics
NPI:1497189708
Name:OVERALL, CLEMENCE GARNEAU (LCSW, RPT-S)
Entity Type:Individual
Prefix:MS
First Name:CLEMENCE
Middle Name:GARNEAU
Last Name:OVERALL
Suffix:
Gender:F
Credentials:LCSW, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3843
Mailing Address - Country:US
Mailing Address - Phone:302-242-8684
Mailing Address - Fax:
Practice Address - Street 1:1010 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3602
Practice Address - Country:US
Practice Address - Phone:302-740-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00007631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical