Provider Demographics
NPI:1154948404
Name:RAESCH, CLAIRE V (LCPC)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:V
Last Name:RAESCH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13420 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-8436
Mailing Address - Country:US
Mailing Address - Phone:409-240-0480
Mailing Address - Fax:
Practice Address - Street 1:13420 THOUSAND OAKS DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-8436
Practice Address - Country:US
Practice Address - Phone:409-240-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93699101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional