Provider Demographics
NPI:1851550925
Name:MANNINO, CLAIRE ELAINE (MS)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELAINE
Last Name:MANNINO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 N STATE ST
Mailing Address - Street 2:SUITE 322
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5037
Mailing Address - Country:US
Mailing Address - Phone:360-224-5334
Mailing Address - Fax:360-841-7736
Practice Address - Street 1:3830 GRIFFITH AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-8528
Practice Address - Country:US
Practice Address - Phone:360-224-5334
Practice Address - Fax:360-841-7736
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60450502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health