Provider Demographics
NPI:1558873174
Name:BOGLE, CLARE FIELDING (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:FIELDING
Last Name:BOGLE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:NEWFIELD
Other - Last Name:FIELDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:19 E WALNUT ST STE D
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4505
Mailing Address - Country:US
Mailing Address - Phone:573-203-5007
Mailing Address - Fax:573-777-1131
Practice Address - Street 1:19 E WALNUT ST STE D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4505
Practice Address - Country:US
Practice Address - Phone:573-203-5007
Practice Address - Fax:573-777-1131
Is Sole Proprietor?:No
Enumeration Date:2017-11-05
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200061071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical