Provider Demographics
NPI:1114252301
Name:CLAYTON, MONICA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681397
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32868-1397
Mailing Address - Country:US
Mailing Address - Phone:407-872-7720
Mailing Address - Fax:
Practice Address - Street 1:259 LIVE OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3829
Practice Address - Country:US
Practice Address - Phone:321-872-7720
Practice Address - Fax:267-203-7063
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2564106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist