Basic Information
Provider Information
NPI: 1184935868
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCLAWHORN
FirstName: CLAUDIA
MiddleName: MICHELLE
NamePrefix: MISS
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2409 HOMER CLAYTON DR
Address2:  
City: GUNTERSVILLE
State: AL
PostalCode: 359762207
CountryCode: US
TelephoneNumber: 2565824240
FaxNumber: 2565824161
Practice Location
Address1: 4040 MEMORIAL PKWY SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358024364
CountryCode: US
TelephoneNumber: 2565331970
FaxNumber: 2567056477
Other Information
ProviderEnumerationDate: 06/28/2010
LastUpdateDate: 10/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  N Behavioral Health & Social Service ProvidersSocial Worker 
104100000X3141GALY Behavioral Health & Social Service ProvidersSocial Worker 

ID Information
IDTypeStateIssuerDescription
33000001405AL MEDICAID


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