Provider Demographics
NPI:1164659462
Name:FOLEY, CLINTON THOMAS
Entity Type:Individual
Prefix:
First Name:CLINTON
Middle Name:THOMAS
Last Name:FOLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 CITY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3332
Mailing Address - Country:US
Mailing Address - Phone:541-520-9353
Mailing Address - Fax:541-683-3748
Practice Address - Street 1:1720 W 25TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-1663
Practice Address - Country:US
Practice Address - Phone:541-343-9706
Practice Address - Fax:541-683-3748
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health