Provider Demographics
NPI:1528293560
Name:MARTIN, CLAIRE TARVES (LSW)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:TARVES
Last Name:MARTIN
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 1:2515 MANSFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1016
Mailing Address - Country:US
Mailing Address - Phone:610-259-0153
Mailing Address - Fax:
Practice Address - Street 1:2515 MANSFIELD AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1016
Practice Address - Country:US
Practice Address - Phone:610-259-0153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW12639104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker