Provider Demographics
NPI:1336215243
Name:CLAFFEY, DONNA C (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:C
Last Name:CLAFFEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CARY WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2069
Mailing Address - Country:US
Mailing Address - Phone:847-516-4251
Mailing Address - Fax:847-639-3510
Practice Address - Street 1:120 W EASTMAN ST STE 305
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5950
Practice Address - Country:US
Practice Address - Phone:847-255-7704
Practice Address - Fax:847-639-3510
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL 149-0036651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001606757OtherBLUE CROSS BLUE SHIELD #