| Clare A. Stadlen, Lcsw, Pllc | |
|
3622 Lyckan Pkwy Suite 3002 Durham NC 27707-2564 | |
| (919) 602-6766 | |
| Not Available |
| Full Name | Clare A. Stadlen, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3622 Lyckan Pkwy, Durham, North Carolina |
| Authorized Official Name and Position | Clare Andrea Stadlen (LICENSED PSYCHOTHERAPIST) |
| Authorized Official Contact | 9196026766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clare A. Stadlen, Lcsw, Pllc 3622 Lyckan Pkwy Suite 3002 Durham NC 27707-2564 Ph: (919) 602-6766 | Clare A. Stadlen, Lcsw, Pllc 3622 Lyckan Pkwy Suite 3002 Durham NC 27707-2564 Ph: (919) 602-6766 |
| NPI Number | 1578939740 |
|---|---|
| Provider Enumeration Date | 08/11/2015 |
| Last Update Date | 08/11/2015 |
| Medicare PECOS PAC ID | 0446672307 |
|---|---|
| Medicare Enrollment ID | O20200623000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578939740 | NPI | - | NPPES |
| 2877131A | Other | NC | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 7485 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C003990 (North Carolina) | Primary |
| Provider Name | Clare A Stadlen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730296922 PECOS PAC ID: 2062309545 Enrollment ID: I20091027000626 |
| Provider Name | Katherine Harris Hanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992331904 PECOS PAC ID: 4486076288 Enrollment ID: I20200624002345 |
| Provider Name | Blair Marini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467090886 PECOS PAC ID: 8022422435 Enrollment ID: I20210126002691 |
| Provider Name | Rebecca Jewel Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184276594 PECOS PAC ID: 8123415304 Enrollment ID: I20220419001375 |
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