Provider Demographics
NPI:1881854263
Name:POWERS, CLARE (LPC)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:
Other - Last Name:MELLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:350 GROVERS AVE UNIT 7H
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-3437
Mailing Address - Country:US
Mailing Address - Phone:914-629-7289
Mailing Address - Fax:
Practice Address - Street 1:21 SHERMAN CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5825
Practice Address - Country:US
Practice Address - Phone:475-999-2349
Practice Address - Fax:203-292-3244
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1704101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional