Provider Demographics
NPI:1306576400
Name:RIORDAN, CLAIRE LAVERNE (MA)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:LAVERNE
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 1/2 KING ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4704
Mailing Address - Country:US
Mailing Address - Phone:503-593-9081
Mailing Address - Fax:
Practice Address - Street 1:112 LAKE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-5284
Practice Address - Country:US
Practice Address - Phone:802-865-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0136271101YM0800X
ORC8601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health