Provider Demographics
NPI:1538685177
Name:EVANS, CLAIRE (MSW, LICSW, BCD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSW, LICSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W HOLLY ST STE 221
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4329
Mailing Address - Country:US
Mailing Address - Phone:360-318-3981
Mailing Address - Fax:
Practice Address - Street 1:203 W HOLLY ST STE 221
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4329
Practice Address - Country:US
Practice Address - Phone:360-318-4981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000062531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical