Provider Demographics
NPI:1184765000
Name:HANCOCK, CLAIRE (LICSW)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 CONGRESS STREET
Mailing Address - Street 2:UNIT 2
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-6065
Mailing Address - Country:US
Mailing Address - Phone:802-851-1030
Mailing Address - Fax:802-851-1044
Practice Address - Street 1:209 CONGRESS ST
Practice Address - Street 2:UNIT 2
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-6065
Practice Address - Country:US
Practice Address - Phone:802-851-1030
Practice Address - Fax:802-851-1044
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT2321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT29365OtherBLUE CROSS PROVIDER NUMBE
VTOVN1585Medicaid
VTOVN1585Medicaid