Provider Demographics
NPI:1558904334
Name:LOOMIS, CLAIRE ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 S HOME AVE
Mailing Address - Street 2:
Mailing Address - City:TOPTON
Mailing Address - State:PA
Mailing Address - Zip Code:19562-1208
Mailing Address - Country:US
Mailing Address - Phone:610-703-5718
Mailing Address - Fax:610-641-0057
Practice Address - Street 1:1 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-1350
Practice Address - Country:US
Practice Address - Phone:610-944-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health