Provider Demographics
NPI:1083914006
Name:CLAYMORE COUNSELING, PLLC
Entity Type:Organization
Organization Name:CLAYMORE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:FLATLEY
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:915-203-6824
Mailing Address - Street 1:4843 OLMOS ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1751
Mailing Address - Country:US
Mailing Address - Phone:915-533-7755
Mailing Address - Fax:915-542-2978
Practice Address - Street 1:1717 BROWN ST STE 2B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4730
Practice Address - Country:US
Practice Address - Phone:915-533-7755
Practice Address - Fax:915-542-2978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX552302363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty