Provider Demographics
NPI:1689716458
Name:CLAPHAM, CAROL E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:E
Last Name:CLAPHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 RIDDLE AVE
Mailing Address - Street 2:APT. 1
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2138
Mailing Address - Country:US
Mailing Address - Phone:302-777-5990
Mailing Address - Fax:610-696-4476
Practice Address - Street 1:310 N MATLACK ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2620
Practice Address - Country:US
Practice Address - Phone:610-696-4900
Practice Address - Fax:610-696-4476
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW000699L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA653738KMBMedicare ID - Type Unspecified