Provider Demographics
NPI:1033430202
Name:CLEMENTS, JAMES R (LPCC, LSW, LICDC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:CLEMENTS
Suffix:
Gender:M
Credentials:LPCC, LSW, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 N STATE ST STE 455
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3994
Mailing Address - Country:US
Mailing Address - Phone:440-352-6191
Mailing Address - Fax:440-953-1608
Practice Address - Street 1:8 N STATE ST STE 455
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3994
Practice Address - Country:US
Practice Address - Phone:440-352-6191
Practice Address - Fax:440-953-1608
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0000614101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional