Provider Demographics
NPI:1043349533
Name:SMITH, CLAYTON (BA)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4378 W SAWMILL CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-2843
Mailing Address - Country:US
Mailing Address - Phone:303-660-5568
Mailing Address - Fax:303-433-9717
Practice Address - Street 1:2829 W 33RD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3231
Practice Address - Country:US
Practice Address - Phone:303-433-3944
Practice Address - Fax:303-433-9717
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health