Provider Demographics
NPI:1861985970
Name:EARL, CLARA (LCSW)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:EARL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-4521
Mailing Address - Country:US
Mailing Address - Phone:208-629-6446
Mailing Address - Fax:
Practice Address - Street 1:112 9TH AVE S # B9
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3825
Practice Address - Country:US
Practice Address - Phone:208-825-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-416341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical