Provider Demographics
NPI:1730891730
Name:ACHIA, CLARE ALLISON
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:ALLISON
Last Name:ACHIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:ALLISON
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1409 EMIL ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1409 EMIL ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2311
Practice Address - Country:US
Practice Address - Phone:608-283-6426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIAPSW134041-121Medicaid