Provider Demographics
NPI:1669750964
Name:GREAVES, CLAIRE AMANDA (LCSW)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:AMANDA
Last Name:GREAVES
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 1:17604 BOY SCOUT RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-5109
Mailing Address - Country:US
Mailing Address - Phone:813-920-9602
Mailing Address - Fax:813-920-9602
Practice Address - Street 1:17604 BOY SCOUT RD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-5109
Practice Address - Country:US
Practice Address - Phone:813-920-9602
Practice Address - Fax:813-920-9602
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00052551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical