Provider Demographics
NPI:1881351096
Name:CLAAR, CORISSA (LSW)
Entity type:Individual
Prefix:
First Name:CORISSA
Middle Name:
Last Name:CLAAR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 LOVELAND AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2052
Mailing Address - Country:US
Mailing Address - Phone:814-312-8986
Mailing Address - Fax:
Practice Address - Street 1:1324 W 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2462
Practice Address - Country:US
Practice Address - Phone:814-835-1700
Practice Address - Fax:814-835-1701
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1388711041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical