Provider Demographics
NPI:1538020953
Name:LOGSDON, CLAIR SUZANNE (MED)
Entity type:Individual
Prefix:MRS
First Name:CLAIR
Middle Name:SUZANNE
Last Name:LOGSDON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458 E GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47805-9573
Mailing Address - Country:US
Mailing Address - Phone:812-230-7496
Mailing Address - Fax:
Practice Address - Street 1:6325 S STATE ROAD 46
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-8917
Practice Address - Country:US
Practice Address - Phone:812-214-5152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN000052781103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical