Provider Demographics
NPI:1053671206
Name:CLAYTON'S CAUSE, LLC
Entity Type:Organization
Organization Name:CLAYTON'S CAUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MISSY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:757-871-9209
Mailing Address - Street 1:PO BOX 12453
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40583-2453
Mailing Address - Country:US
Mailing Address - Phone:757-871-9209
Mailing Address - Fax:888-398-7035
Practice Address - Street 1:194 SWIGERT AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-1902
Practice Address - Country:US
Practice Address - Phone:757-871-9209
Practice Address - Fax:888-398-7035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-5250103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty