Eleanor Kline Claycomb, M.ED L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4296-123 Issued in WI

Practice address

504 Lakeland Rd
Shawano, WI 54166-3836

Phone

(715) 526-5547

Fax

(715) 526-5542

NPI assigned

Sep 6, 2007

Last updated

Sep 3, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Eleanor Kline Claycomb Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1750576385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 LAKELAND RD",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663836",
            "telephone_number": "715-526-5547",
            "fax_number": "715-526-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 LAKELAND RD",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663836",
            "telephone_number": "715-526-5547",
            "fax_number": "715-526-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYCOMB",
        "first_name": "ELEANOR",
        "middle_name": "KLINE",
        "name_prefix": "Mrs.",
        "credential": "M.ED L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "4296-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39212900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "CLAYCOMB",
            "middle_name": "KLINE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Clay A Canaday, DO
• Kary L Cappaert, APNP
• Angela Carlson, COTA
• Casey M Carroll
• Deborah Chinana, LPC
• Vickiemarie Cloutier, MD
• Jane Laurie Coleman, MSE,LPC
• Kylie Colwell
• Cornerstone Chiropractic & Wellness LLC
• Countryview Chiropractic Clinic, S.C.

• Clinical Social Worker in Shawano, WI
• Providers in Shawano, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.