Provider Demographics
NPI:1982040739
Name:ERNEST, CLARE M (MSED)
Entity Type:Individual
Prefix:MS
First Name:CLARE
Middle Name:M
Last Name:ERNEST
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 93RD ST
Mailing Address - Street 2:APT. B-6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6951
Mailing Address - Country:US
Mailing Address - Phone:917-204-6503
Mailing Address - Fax:
Practice Address - Street 1:364 93RD ST
Practice Address - Street 2:APT. B-6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6951
Practice Address - Country:US
Practice Address - Phone:917-204-6503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1221868103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst