Provider Demographics
NPI:1073560843
Name:PEET, CLAYTON (LSCSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:
Last Name:PEET
Suffix:
Gender:M
Credentials:LSCSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9333 EAST 21ST STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209
Mailing Address - Country:US
Mailing Address - Phone:316-634-4750
Mailing Address - Fax:316-634-4770
Practice Address - Street 1:9333 EAST 21ST STREET NORTH
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209
Practice Address - Country:US
Practice Address - Phone:316-634-4750
Practice Address - Fax:316-634-4770
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004469A1041C0700X
KS36441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical