Provider Demographics
NPI:1184402216
Name:PENY, CLAIRE MARIE
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIE
Last Name:PENY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12321 SLEEPY LAKE CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2869
Mailing Address - Country:US
Mailing Address - Phone:571-480-1031
Mailing Address - Fax:
Practice Address - Street 1:8230 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:TYSONS
Practice Address - State:VA
Practice Address - Zip Code:22182-2639
Practice Address - Country:US
Practice Address - Phone:215-208-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician