Provider Demographics
NPI:1508453614
Name:CLOUSER, CARLIE MAE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:CARLIE
Middle Name:MAE
Last Name:CLOUSER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MISS
Other - First Name:CARLIE
Other - Middle Name:MAE
Other - Last Name:LEPLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 MANOR DR STE 209
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4936
Mailing Address - Country:US
Mailing Address - Phone:717-790-1700
Mailing Address - Fax:
Practice Address - Street 1:1215 MANOR DR STE 209
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4936
Practice Address - Country:US
Practice Address - Phone:717-790-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
PASW139388101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker