Provider Demographics
NPI:1962261818
Name:WILSON, CLAIRE ANNE (BSW,MSW,LCASA,LCSWA)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ANNE
Last Name:WILSON
Suffix:
Gender:F
Credentials:BSW,MSW,LCASA,LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CONNEMARA DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-5862
Mailing Address - Country:US
Mailing Address - Phone:919-454-8296
Mailing Address - Fax:
Practice Address - Street 1:RALEIGH 2709 BLUE RIDGE RD. SUITE 190
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27519
Practice Address - Country:US
Practice Address - Phone:919-877-6458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-28987101YA0400X
NCP0200891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)