Healthcare Provider Details

I. General information

NPI: 1184765000
Provider Name (Legal Business Name): CLAIRE HANCOCK LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 CONGRESS ST UNIT 2
MORRISVILLE VT
05661-6065
US

IV. Provider business mailing address

209 CONGRESS STREET UNIT 2
MORRISVILLE VT
05661-6065
US

V. Phone/Fax

Practice location:
  • Phone: 802-851-1030
  • Fax: 802-851-1044
Mailing address:
  • Phone: 802-851-1030
  • Fax: 802-851-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number232
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: