Provider Demographics
NPI:1245869049
Name:DEPRIEST, CLAIRE C (LCSW)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:C
Last Name:DEPRIEST
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 1:222 S REESE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-4517
Mailing Address - Country:US
Mailing Address - Phone:901-248-4813
Mailing Address - Fax:
Practice Address - Street 1:240 MADISON AVE STE 602
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2770
Practice Address - Country:US
Practice Address - Phone:901-248-4813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN72191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical