Provider Demographics
NPI:1003014754
Name:CLAYTON, SUSAN V (EDD, LPC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:V
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 MAIMONE ST
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8328
Mailing Address - Country:US
Mailing Address - Phone:732-341-1595
Mailing Address - Fax:
Practice Address - Street 1:1116 MAIMONE ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8328
Practice Address - Country:US
Practice Address - Phone:732-341-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00079900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional