Healthcare Provider Details

I. General information

NPI: 1306916911
Provider Name (Legal Business Name): CLAIRE L PRESTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAIRE P LOWERY LCSW

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8225 AL HIGHWAY 75
HORTON AL
35980-8473
US

IV. Provider business mailing address

PO BOX 97
GADSDEN AL
35902-0097
US

V. Phone/Fax

Practice location:
  • Phone: 256-593-3804
  • Fax:
Mailing address:
  • Phone: 256-492-0131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2165C
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier51594755
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBLUE CROSS AND BLUE SHIELD
# 2
Identifier511-59442
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBLUE CROSS (CULLMAN)
# 3
Identifier330000025
Identifier TypeMEDICAID
Identifier StateAL
Identifier Issuer
# 4
Identifier511-59443
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBLUE CROSS (DOUGLAS)
# 5
Identifier193484 (CULLMAN)
Identifier TypeMEDICAID
Identifier StateAL
Identifier Issuer
# 6
Identifier176508 (DOUGLAS)
Identifier TypeMEDICAID
Identifier StateAL
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: