Provider Demographics
NPI:1609507797
Name:SANGUEDOLCE, CLAIRE NICOLE (LCSWA)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:NICOLE
Last Name:SANGUEDOLCE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E HAMMOND ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-4423
Mailing Address - Country:US
Mailing Address - Phone:805-807-5142
Mailing Address - Fax:
Practice Address - Street 1:409 E HAMMOND ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-4423
Practice Address - Country:US
Practice Address - Phone:984-224-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0176181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical