Provider Demographics
NPI:1619540812
Name:LIZA CLAPHAM LCSW LLC
Entity type:Organization
Organization Name:LIZA CLAPHAM LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLAPHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-281-2749
Mailing Address - Street 1:PO BOX 26203
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19899-6203
Mailing Address - Country:US
Mailing Address - Phone:302-281-2749
Mailing Address - Fax:302-543-5097
Practice Address - Street 1:1608 NEWPORT GAP PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-6208
Practice Address - Country:US
Practice Address - Phone:302-281-2749
Practice Address - Fax:302-543-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE004634329OtherHIGHMARK BCBS
DE000593172Medicaid