Provider Demographics
NPI:1649628686
Name:CRALL, CLARA (LISW)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:CRALL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:
Other - Last Name:REARDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2121 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101
Mailing Address - Country:US
Mailing Address - Phone:304-485-1721
Mailing Address - Fax:304-927-5201
Practice Address - Street 1:2121 7TH ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101
Practice Address - Country:US
Practice Address - Phone:304-485-1721
Practice Address - Fax:304-927-5201
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker