Provider Demographics
NPI:1013447374
Name:ROWELL, CLARETHA (LCSWA)
Entity type:Individual
Prefix:MS
First Name:CLARETHA
Middle Name:
Last Name:ROWELL
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 1:4035 UNIVERSITY PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3275
Mailing Address - Country:US
Mailing Address - Phone:336-397-1560
Mailing Address - Fax:336-397-1566
Practice Address - Street 1:4035 UNIVERSITY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3275
Practice Address - Country:US
Practice Address - Phone:336-397-1560
Practice Address - Fax:336-397-1566
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP011335104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker